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ll if VLI V0 1UG LV.J'! C:L1 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT_,) � -� �'O� - PHONE NO - <br /> ADDRESS <br /> AGENCY NAME 'PHONE NO <br /> ADDRI3SS <br /> d72:: Lr, OX '75-los— <br /> FULL <br /> 5- os'FULL ADDRESS BUSINESS 1V4PRO -RAM OR <br /> FACILITY TYPE QF FTI,F.' <br /> Vit% 'J!•7 �I /l `A <br /> :��x'� at<•s�T.t�hy rt�rff F'/p V�17 '�-l�o► I.t/`D_ Q�VL� �►�1rt/ <br /> _ /4�s"d .1 __rt X.r�X.�b Gte�tiZdG�T�lr�/�- F-il/ G�,! /V�O�A��oC.CC�,7USZ 'iG <br /> % I�r�LM99"& 1&091 91 I 4C <br /> `(d D.f. 7W4 qt�1Cd de ,C4A47-re771le 4W <br /> v,��r�ff� <br /> ��r1 <br /> L <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THF PURI IC HFALIH <br /> SERVICLSiENVIRONMENTAL HEALTIA DIVISION (EHb) 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 J101 PREMISE ADDRESSES PER REQUEST <br /> 2- PUBLIC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PHOCESS- <br /> ED BY CALLING (209146&3420- OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 MOON AND 1:00 TO 4:30 PM. <br /> 3. A PUBLIC FILL=SIRECORDS 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 RE BILLED TO THE APPLICANT FOR PA.YMENT. (SEE EHD POLICY .94- 0071 <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT FE REMOVED FROM THE EHD VREN1119ES. <br /> saaa•••AFt+•r•.r.••♦sr��+••asfs+sem♦+++Ka•••**!fy•1•/It;A}f1t+��••••f♦i1a♦•T <br /> SIGNATURE OF APPLICAN l�f ' L�� DATE <br /> SIGNATURE OF RFLEASING OFFICIAL DATE <br /> EH 00 14 !REV 9196) <br />