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Eli OU 14 (REV $194) 5AN 1VAQUIN COUNTY / 7 <br /> PUBLIC 11EAL"I SERVICES 9 <br /> ENVIRONMENTAL H&U,71711 D"1014 <br /> I„UB1,41C RECORDS RELEASE APPLICATION <br /> PHONE NO <br /> APPLICANT 1 cs 2 i C t1J •2.o 4- L -S�r I <br /> ADDRESS (v 7-N c=:1- <br /> AGENCY NAME TQ r,, Cif <br /> PFIDNS NO 5 .•i <br /> ADDRESS 'S <br /> EILa ADDRM I.EAI��SiB1YG�C ' <br /> 2 51p P� P,ti.n L�t>•1�Rn P <br /> 77119 NONCE t9 SUBJECT TO T148REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> OAQUINANCE MDE QP SAN <br /> NMCOVlIRON r-N TAL PI 1413ALANTI I DIV3BRSICN (C11D) RE50UJ TIOpOUCy#94-W7, <br /> NS, WATL•R CODE- <br /> GOV URNMLINT CODH AND TOR EVIDENCE COP <br /> ]. A MAXIMUM Or TSN (10) PREMISE AUMESSaS PER MQURSr. <br /> 2. t*vauc nt.ssIaecaaus RgvlHw n by ptt%ffnjHi314S13.Y• <br /> AM"NTFiENTS ARE ARRAWMV by <br /> CALUNO (2041/68-0340. OrrIC9 IH"s PoR APMLW MENTB ARA toirnuux MONDAT TIIRU FuDA-r <br /> EMCLUD'NO HOLIDAYS, S:OO A/4-M 12.90 NOON ANo 1'00 PM TO 4.30 PM. <br /> 3. A PUBLIC RACORDS RXLRAXE An"bCATION (''RRA)IS RAQUUCED. <br /> 4. public FILIWRLC1oRD9 NOT RaTURNEIT iN TIM SAME CONDITION AS RECE"D WILL as CoRREctm <br /> at' TIIiI END STAFF AT THM EXPEI'I!R ON TIM APPLICANT. Tllb ADp(i1ONAL SERYIC$ WILL BA BtI.t.ED 'LO Tar <br /> FOR PAYMENT. (Sn EHD POLICY 44007) <br /> S. aRIdI�PUBLIMC FILSS/RLCORpS SHALL NOT I 7tA•l01'fiD FROM TILE GHD 17Cp].IISW.SIGNATURE CANP DATE z <br /> SIONATURBOF REWASINO OFFICIAL DATH <br /> No M_VEJID RN(.'ORDS/FUXS ARb 1D6NffrEbb: <br /> ..�.�.,. ra�a. <br /> PHSIMID Ra,cDRD31MEs EX18T ON TNR ADOM"(99)NOTED, YOU WILL aM NOTIFIED 7m, <br /> FtoCoRMMLE8 ARM AVAILAMC POR RZYILWI ,..,....,.«o... <br />