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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES �I�I�S j' L- Ly <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT YJl li h h PHONE NO <br /> ADDRESS E- h <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> FILE ADDRESS LEAD AGENCY DATE <br /> 10 � 1HS-9s <br /> s <br /> 760 1 1Dr;Yc /�, <br /> �i )C 1 5 • A i rperr-T W a., P-.LS <br /> 144 rnc�t Wim., <br /> ) G za � 2.R T 15 <br /> D I R cl w>41 <br /> 493 7 iW Lo. <br /> 4-3 <br /> 0 -7 5, r_i 0c-r-c�A , <br /> 0 u [ b(- <br /> THIS <br /> r.THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION(EEM) POLICY#94-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EEID FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXRvfIIM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW Is BY APPOINTMENT ONLY. APPOINfv(ENTs 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 F=lRECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WB.L BE CORRECTED <br /> BY THE E D 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 EEM PREMISES. <br /> SIGNATURE OF APPLICANT DATE c <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> No PHS/El-ID RECORDs/FILEs ARE IDENTIFIED: <br /> Dwiv: Revues®BY: No,me�nan Dntc <br /> PHS/E I) RECORDS/FII.Es EMT ON THE ADDRESS(ES) NOTED. YOU WILL BE NOTIFIED WHEN <br /> RECORDS/FILES ARE AVAILABLE FOR REVIEW: <br /> �-� D. Mvnw®m !Immunes+Mre: <br /> 1 JI <br />