Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> /P;UBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT�Q/Y)VII I� Y PHONE NO <br /> ADDRESS - (SU GM r7rrl �Za`F <br /> AGENCY NAMECOIrlt4l Ml)tW 7-r06)?_ (_,I. PHONE NO <br /> ADDRESS ZZrI Al UIrIC(��/uU ���� TD� <br /> +x+x+++++x++x++++++++xxx++xx+++++++x++x+++++x++++x+++x+++++++++xx <br /> FULL ADDRESS BUSINESS NAME/ PROGRAM OR <br /> FACILITY TYPE OF FILE <br /> �� (!nnyty,ll �ic�C✓ TrcuclaW'�.�-) -•— - 'r <br /> I q orCoriv <br /> � (a li niCl Cls 12aSo'� <br /> r <br /> -� q 7 vc� <br /> x++x++x++x++xx+xxx++x+xx+xk+++++xx++x++x++x+++++++++xx++x+++*++xx <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, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1 . A MAXIMUM OF TEN (1�0, 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 FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> ................... ............... ... ............................ <br /> SIGNATURE OF APPLICANT'G �. �• DATE (L <br /> 1 -142 <br /> SIGNATURE OF RELEASING OFFICIAL in ' it IIATE (� <br /> EH 00 14 (REV 9/96) <br />