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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT L PHONE NO <br /> ADDRESS 22-2l— yf'r <br /> AGENCY NAME CD <br /> ADDRESS <br /> PHONE NO <br /> FULL ADDRESS BUSINESS NAME/ PROGRAM OR <br /> iF'ACILITY TYPE OF FILE <br /> (U G u o <br /> c <br /> ?__`L'S� <br /> Lo v B <br /> L4 Cc Ezne.1LC"C _IP L A^/i✓ OH U <br /> k <br /> rr+44-Geu F,-a-e,L_Cuc�o _ JTC Tit Gs (,ra,. tcs,�r.. _23`Qo z37-f t/ <br /> v I ------------- <br /> 4 <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) POLICY #94-007, ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING (209)468-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> 3. A PUBLIC FILES/RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 007) <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> •++++++++++asaeae++ase+a+ae//++aiee+taeaee+aea+aa+++++aa++++a++eesea+at+eae+ <br /> SIGNATURE OF APPLICANT .�-+ 1 / // DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 9/96) <br />