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Hlll 'i may( VJ7:44HI9 bPi11F1 It'�Yn YVV..^vl i._Rrvrn +� r � . <br /> 11-13-1995 62:54PM FKL <br /> SAN JOAQIIIN COUNTY <br /> PUBLIC HBALT-a SERVICES <br /> BNVIEONMSd'I'AT+ Fi&AI,TH DIz1ISION <br /> PuBl'TC RECORDS RELEASE APPLICATION <br /> HONE <br /> PNO <br /> Jpr�oLlC]3NTT_�•..m' �Sm.�-`� �Cc .. gni . - C cam_ <br /> ADDRESSG <br /> < ` PHONE NO <br /> AG 3NCY NAME <br /> ADDRESS <br /> t*t'1'***x�"k+ttttt+t+*xxx*xt**itxe+rirY'+**x'k X'kx*'�"t•k*r#er+�rr'A'+x*era <br /> +eRLZTY AIAMFMt'L TYPHI <br /> •S l 1 ,1 S !� K be �-�" s. <br /> i <br /> +itY'M't*1*it***}*t*3k'�x��Y=Yt*****•l'*t*********%X�'*Y*�k't** F*1t*t*'k'kf Y't <br /> THIS NOTICE IS 9uBJEC7 TO THE REQUIREMENTS IDENTIFIED IN THE'PUIBUIINANCE CODE OF <br /> C HEALTH <br /> CY 094-007. ORO <br /> SEWVJ ES/E VN ICONIM NTEHD FEE ANDLTH IS RIVOICE CHARGE <br /> IONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> QUEST <br /> 1. A MAXIMUM OF TF LIQ, PREMISE ADDRESSES PER RE <br /> 2. PUBLIC FILES - 420. <br /> REVIEW IS 8Y &PI!UAVa €NTS + APPOINTMENTS ARE P({OCE55- <br /> RE <br /> { ED 9)4683H0UDAYS, 8:00 AM TORAPPOINTMENTS A <br /> 12:00 NOON AND 1:00 TO AD30 PMMONDAY <br /> THRU FRIDAY EXCLUDING <br /> 3. A PUBLIC FILES/RECORDS RELEASE APPLICATION {PRRAI IS REQUIRED. <br /> Cm VED WILL <br /> 4. PUBLIC rCORRECTEDILE <br /> 6YS IRCORDS NOT RETURNED IN THE SAME CONDITION <br /> HE6 EHD STAFF Al THE EXPENSE Cr HE APPLICANTATHIS ADDITIONAL E <br /> SERVICE WILL BE GILLED TO THE APPLfOANT FCR PAYMENT- ISEE EHD POLICY 9b- 007) <br /> 5. ORIGINAL PUBLIC FIL'eSIRECOROS SHALL NOT Be REMOVED MOM THE EHD PREMISES. <br /> .........t........++.t+t+�.....•.....t.++++r e.t+.* DATE•....... <br /> •S]�-♦•--�J-^ t+++s <br /> SIGNATURE OF APPLICANT � <br /> SIGNATURE OF RELEASING OFFlC1AL <br /> DATES-- <br /> FH 00 14 (REV 9196) <br /> TOTFL P.02 <br />