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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> / / <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT GyO �- �S Cts C PHONE NO 2 ) 'S'G T moi' o / <br /> ADDRESS 3 0 7 n S N U✓ Y �J <br /> AGENCY NAME p W A) t 2 IPIJONE NO <br /> ADDRESS 3o Yo IVY h 9 ` L/ S <br /> ++tttt++tt+++tt+++tt++tt+tt++ttt+tttttt+++ttt++ttt++tt+++++t+++++ <br /> FULL ADDRESS BUSINESS NAME/ PROGRAM OR <br /> FACILITY nn yy�� TYPE OF FILE <br /> hlyv <br /> 7 O _/o <br /> 2- <br /> ttt+++ttt*++*t***********t**ttt+*+tt*++tttttt++tt+++tttt+tttt+ttt <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 /> SIGNATURE OF APPLICANT ••• '+•+• j a•"•;'••'• DATE <br /> j" �j ++~•;*+ <br /> SIGNATURE OF RELEASING OFFICIAL lx 1TE <br /> EH 00 14 (REV 9/96) <br />