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1: r SAN JOAQUIN COUNTY <br /> .PUBLIC HEALTH SERVICES <br /> ENVIRONACENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> ,APPLICANT �j I m A eC 0-C�_ PHONg NO-617 3 3z, 'Fq/ <br /> ADDRESS c_ . <br /> AGBhTCY NAME _ EP�_TXcp Erl v l,PcjJ. PHONE NO <br /> ADDRESS <br /> FILE ADDRESS LEAD AOMCY Fad <br /> P0i27 ,r ST6C�T0n1 <br /> C0CJ nl - -- <br /> A <br /> pa <br /> jr <br /> NVIRUN�F11TA�trH STH <br /> A� <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION(EHD)POLICY#92m007,ORDINANCE CODE OF SAN <br /> JOAQUiN COUNTY, MiD BEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILESIRECORDS REVIEW ARE BY AMINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS. 8:00 A.M. TO 12:00 NOON ANT) 1,00 P,M, TO 4.30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUNDABi is DEPOSIT OF$78.00„ <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WFII-IIN THE CUSTODY OF THE EHD. <br /> 4. THE A13OVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE MQ_ TO REVIEWING THE <br /> DOCUMENT(S). <br /> S. PUBLIC FILES/RECORDS NOT RETURNED IN THB SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. 'IRIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FILES/RECORD5 SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> �j SIGNATURE OF APPLICANT t rv� �� �` DA17E `174-7/ <br /> �C � I <br /> SIGNATURE OF RELEASING OFFICIAL DATE 1 <br /> PH 00 14 (REV 12192) - <br />