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i - <br /> q-7 <br /> if SAN JOAQUIN COUNTY <br /> PUBLIC HF.ALTH SERVICES <br /> i ENVYRONMENTAI, RIEALT11 DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> ' l( PHONE NO I/C. <br /> APP ICANT ' <br /> C-'�— <br /> ArJD#SS�^H�1 `7Y"' �r y PFi7NE NO <br /> AGS CY NAME_ CLW�—r _Q, <br /> i AI`.D�ESS <br /> i <br /> f ROGR.AM -0 <br /> i <br /> FULL' ADDRESS g5J5INE55 N_AME� ' <br /> FACz I'?1'sr TYPE DF FI�J E . <br /> 1 ` e (� <br /> I <br /> -jo <br /> ell <br /> cc <br /> � I , <br /> I <br /> THIS NICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUKIC HEALTH <br /> SF _Ht))HEALTH DIVISION IF POLICY #j4-Oa7, ORDINANCE CODE OF <br /> SANJpaQUi{v COUNTY, EH1? FEE AND SERVICE CHARGE RESOLUTIONS. STATE WATER 'CODE, <br /> GIJ1lE�NMENT CODE AND THE EVIDENCE CODE- <br /> ' I - <br /> 1. A AXIMUM OPTFC( ?] PREMISE ADDRESSES PER REQUEST- <br /> 2, PUBLIC FlLESlRECORDS REVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED:BY, C1�LLING {2094fi8-3420: OFFICE FLOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRu r-giDAY EXCLUDING HOLIDAYS..8:00 AM TO 12:5}{1 NOON AND 1:00 TO 4:30 PM. <br /> J � <br /> 3. A PUBLIC FILESIR CORDS RELEASE APPLICATION IPRRA) IS REQUIRED. <br /> �. PUBUC FILESlRECORD5 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 PI�YMENT. ISEE END POLICY 94- 007) <br /> S. ORICIWAL PUBLIC FILESMECORDS SMALL NOT BE REMOVED FROM THE EHO PREMISES- <br /> .. r I.. s s.a.• ...r r. <br /> k e f 4 1r .... ...........a...a r--►.�s�� •a a+r a:.-���r <br /> l <br /> 1 SIGNATURE QF APPLICANTDATI: <br /> SIGNA TURF OF RELEASING OrFIC1AL -DATE <br /> EN 00 1 a [REV 91961 <br />