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r_7 <br /> M1� <br /> JI <br /> 'tl <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES .. <br /> ENVIRONMENTAL HEALTH DIVISION v <br /> PUBLIC <br /> � RECORDS RELEASE APPLICATION <br /> �� IW <br /> APPLICANT <br /> ( fA- PHONE NO 2061 - 'U(O� ' 3�0� <br /> ADDRESS 2.. . f1A I A ✓lam <br /> AGENCY NAME Wi A.VV1L1 201\ PHONE NO <br /> ADDRESS 5LI ,.a. e <br /> FULL ADDRESS BUSINESS NAME/ PROGRAM OR <br /> FACILITY TYPE OF FILE <br /> Lip lLa�—('�m l - os S Nti <br /> in. Ka <br /> 5m) If-; . I A l_A fe7L <br /> Ilj (J ' .'R/1CKINY(0_m TRV4 N1a X'9-f-0�( 132'La 65s^;p^ Ali a1-e� P <br /> _ A u� <br /> -� _ate► rTV W -7o <br /> r <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) POLICY 1194-007, 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)4683420. 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 /> •aararrrar+*•ra+aarrrar-A. rrrr•r+'rns• rrrrraaraarr+ra♦r+rra arar+rrrrrrrra+a <br /> SIGNATURE OF APPLICANT '/I LAA /V l n/ DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 9/96) <br />