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.,.L.)SAN JOAQUIN COUNTY <br />PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLJCAN`I'3 MaR-T'y _ PHONE NO <br />ADDRESS <br />AGENCY NAME G EDI,aCh l CAI_ I� s+VGS _ . _ PHONE NO <br />ADDRESS I <br />TIIIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br />SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) 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 />A MAXIMUM OF T13N (10) PREMISE ADDRESSES PER REQUEST. <br />2. PUBLIC FILESI"CORDS REVIEW ARE BY JOINT ENT 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 ANDA O -REFU A �E DEPOSIT OF $78.00 <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 DUE AND PAYABLE PRIOR TO REVIEWING THE <br />DOCUMENT(S). <br />5. PUB11C FILESIRECORDS 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. <br />6. - ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br />SIGNATURE OF APPLICANT/ fij,4i DATE <br />SIGNATURE OF RELEASING OFFICIAL .. DATE <br />E11 00 14 (REV 12192) <br />