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RECEIVED <br />f� <br />NflV 0 8 19�g <br />tyVIR %' iV1 rte !OAQUIN COUNTY <br />WICtS�H PUBBLI� <br />PUBLIC HEALTH SERVICES <br />SER ENVIRONMENTAL HEALTH DIVISION <br />/� PU/jB�L—IC RECORDS RELEASE APPLICATION <br />APPLICANT BIIZ V. � w F PHONE NO �zg—cy 5z <br />ADDRESS "t 3 <br />AGENCY NAME PHONE NO <br />ADDRESS <br />FULL ADDRESS <br />BUSINESS NAME <br />FACILITY <br />IA'eeL�� j r+�ck QL r...2 <br />i ire StiO� <br />PROGRAM OR <br />TYPE OF FILE <br />a9 -o <br />/6 _23 <br />.2 3p/ <br />22 2E4- - <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, END FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br />GOVERNMENT CODE AND THE EVIDENCE CODE. <br />A MAXIMUM OF TEN I 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 FILESIRECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br />++rrrr •rrrrr++rrrarrrrrit r ss ••+ra*_*;.ra+ar'a-*++�rrr�arr+ssrrrt+araa*er+is <br />SIGNATURE OF APPLICANT DATE <br />SIGNATURE OF RELEASING OFFICIAL <br />EH 00 14 (REV 9/96) <br />DATE <br />��e.d_. 94 c"nzw I I // --t-19 C) <br />