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+ ' 10-16-1995 3:59PM FROM AGE NC 209 956 0700 I , pP. 1 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALIM SERVICES VVVV 3 14 Lf <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPucANT T G I �td ' «Q .,,o n m, l NONE NO �a�i� C15 b OZ b+� <br /> ADDRESS ISa!z ^AAAc.h LR I Svs(2 I[F S4-,&Ma C !-I 9S'ZQ i <br /> AGENCY NAME S1+ro Jnr.r [' �� -7 PHONE NO <br /> ADDRESS ' <br /> FILE R ADDRESS LEAD AGENCY DATE <br /> 0 Sys E. PNc Sr[e i- 3Lors1 f" S 53 .3 a7 I}ta 7 <br /> A Ib 5. ch�ry Ke lane <br /> C-twm)Sev �' � /,n!>i .3.5•�� moi*---f1t <br /> _225 S, C>IP1nK�v_ Gn�1,.�,nv,: - a• i. <br /> `� SSl E. LaOi 3s ^N-e - <br /> � <br /> ✓C Zoo N, b£CKffytn RpF}� 1 <br /> ✓o Seo I_. UiC}or RoI <br /> -]NIS NOTICE IS SU141ECP TO THE REQUIREMENTS IDENTIFIED IN 774E PUBLIC HEAIAH <br /> SERVICBSIENVIRONMF.NTAI.HEALTII DIVISION(17110) P6LICY#92-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, S'L'ATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)46!-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCL..UDING HOLIDAYS, 8:00 A.M. TO 1200 NOON AND 1.00 P-M. TO 4:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPIJCATION AND A NON-REFUNDABLE DEPOSIT OF $79.00 <br /> IS REQUIRED- DEPOSITS WILL BE RETURNED -TO THE APPLICANT IF THE FILESIRECORDS AkE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF TILE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIG TO REVIEWING THE <br /> DOCUMENT(S). <br /> 5. PUBLIC FILESIRECORDS 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. <br /> 6. ORIGINAL PUBLIC FIL.LS[L4HCORDS SHALL NOT BL, REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT LYV1�Qe/`i DATE / / 9 SIGNATURE OF RELEASING OFFICIAL DATE <br /> / n Eli 00 14 (REV 17./92) <br />