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WWI SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVI RONMFA NTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT _ t"�G ►� PHONE NO <br /> ADDRESS C- `-'V h <br /> AGENCY NAME PHONE NO <br /> ADDRESS , <br /> FILE ADDRESS LEAD AGENCY DATE <br /> 10 )' l 1Adu5+r►i' R- C <br /> -7L O I . Dries <br /> yt I i 5 • A i r o rr--r 1/J ., �L .�S <br /> O t r Lo , <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 SAN <br /> JOAQUIN COUNTY, E 4D FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10) PREvUSE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE ARRANGED BY <br /> CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY THRU FRIDAY <br /> EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 PM To 4:30 PM- <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE CORRECTED <br /> BY THE EBD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL SERVICE WILL BE BILLED TO THE <br /> APPLICANT FOR PAYMENT. (SEE EHD POLICY 94-007) <br /> S. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EBD PREMISES. <br /> SIGNATURE OF APPLICANT 1' DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> No PHS/EBD REcORDs/FILEs ARE mENTIFIED: <br /> DAil: Ravmw®•T: Noruxana+DAm <br /> PHS/EHD RECORDS/FILES EXIST ON THE ADDRESS(ES) NOTED. YOU WILL BE NOTIFIED WHEN <br /> RECORDS/F= ARE AVAILABLE FOR REVIEW: <br /> DA m Revarw®m NmurcAmw DAts: <br /> MI 0014 (REV 3794) <br />