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12-10-19% g1=33AM FROM TIi 14083712010 �P.02 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH STMVICES <br /> ENVIRONM9NT_k6 HEALTH DIVISION <br /> nnII <br /> PUBLICRECORDSRELEASE APPLICATION <br /> AFPLICilNT f VA l rr, ti I/�e. f __PHONE NO LeoF2 a 7 I — G kO I:) <br /> ADDRESSSLo�g,yy C���200 e[tMn e <br /> AGENCY NAME 1/a uv ,�'cc I„....r fi� � PftONB-� c <br /> ADDRESS (S'• --� - — <br /> t+titwt+rt+ra+aa+aaar+w++artarrtaa+aaaaa+aaaaa+aw+++ata#r#*+*aa++ <br /> FULL ADDRESS BUSINESS NAME/ PROGRAM OR" <br /> [ FACILITY TYPE OF FILE <br /> ISS .SouTti I✓(air�,S'J. /�'jG•rrKw- �ia^•ar.o1 Lyn.6Pr �u� esSir.e,-.f <br /> cL•-.I <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICESlENVIRONMENTAL HEALTH DIVISION IEHD) POLICY 994.007, ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY. EHO FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE. <br /> GOVERNMENT CODE AND THE EVIDENCF CODE. <br /> 1. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILES(RECORDS REVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING 1299M683420. 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 FILESIRECORDS RELEASE APPLICATION IPRRAI IS REQUIRED. <br /> 4. PUBLIC FILESIRECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THF EXPEMSF OF 11IE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL RE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 007) <br /> 5. ORIGINAL PUBLIC FILE /RECORD <br /> ALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> ...... f •tr s. . .....+a.aua...... <br /> SIGNATURE OF APPLICANT �� ��.. DgTE ✓mac I/�(o <br /> SIGNATURE OF RELEASING OFFICIAL_----- OATF <br /> Ell 00 14 IR EV 9199) <br />