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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Slcue A�vc PHONE NO 1% 441-3s'70 <br /> ADDRESS If578 Tydao Ra• #A <br /> AGENCY NAME Pr, lMwes1- MWAWCOW PHONE NO cn 649-3670 <br /> ADDRESS 1879 Tctdu.b FJ. 4A <br /> FILE ADDRESS LEAD AGENCY PATH <br /> �p I W rJ1" LaNC+ <br /> 3z30 N V rj - bvvr; SrF <br /> Iz35 At ,tw 4"Ve- E LDP <br /> cxvv j KPF IL1tE Al�jl� <br /> Bdl 0uhjwHN L 15?$ UL Pr"Al F-4 <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION(END)POLICY#92,007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES 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 FII.ESMECORDS REVIEW. ARE BY APPOINIMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468.0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUNDABLE DEPOSfI 0178.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUB AND PAYABLE PRIOR TO REVIEWING TILE <br /> m DOCUMENT(S). <br /> J 5. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> �va CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT DATE z�2 I�9t <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 12/92) <br /> Tn'J CTnn(rppTCT ^" inn JJ U^^•^ri nCC T_nT-CCl <br />