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/ v <br /> , <br /> SAl,l JOAQUIN COUNTY <br /> PUBI.jC 11SALTEE SERVICES <br /> ENVIRONMENTAL EEEALI'll D.LVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> plIONC NO F y q Y <br /> AI)()RESS PEIUNE NO <br /> AGF,t-I CY NAME <br /> ADDRESS <br /> USINCSS NAMEL PROG&AM OR <br /> FULL AJ�URSS I3F11C1LI"IY TYPE OF FILE <br /> k # k k # # k k*## k* k k* k# k k k k#* k# k k k k* k k k k ** k k# k 4'####*## ##** k**# k <br /> TI ii; R10 I,ICF IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTALCUNT , DIFEE ANDDIVISION <br /> ICE CHARGE POLICY <br /> RESOLUTIONS, STATE WATER CODE, <br /> DE OF <br /> SAN JOAOUIN COUNTY, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1 . A MAXIMUM! OF TEN LLoj PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY Af'POINTNIEN�oN7MCRlTSOARE SE EbTS 11LEb MONDAY <br /> PROCESS- <br /> ED RY rAI I,INc; 17QJ1�1tiB 3�t20. OFF,(-.p I1t�URS r0l, AP <br /> TI IRU 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 (PRRAI IS REQUIRED. <br /> 4. PUBLIC FILESIRECORUS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> IONAL <br /> CORRECTED TIIILLED TO THE APPLICANT FOR PAYMENEHD STAFF AT THE EXPENSE OF THE T. (SEE EHD POLICY 94-PLICANT. THIS 0007) <br /> SERVICE WILLL 8E B <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> e s • • ass a e s e a m e e • a a s m s e e s s.j e e s s e s e s s s♦e e e e s e e s s e e s a e e s e e e s a s e e e e . s e a e s e e m e e s <br /> SIGNATURE OF APPLICANT <br /> DATE / �? 3 A�_ <br /> SIGNATURE OF RELEASING OFFICIAL <br /> DATE <br /> EH 00 14 (REV 9/96) <br />