Laserfiche WebLink
k <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES( <br /> ENVIRONMENTAL REALT H DD ISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT PHONE NO 'Z -3 t(� <br /> ADDRESS 2 S Z-7 G4 • z 7 <br /> AGENCY NAME —Fw-►�-j PHONE <br /> ADDRESS <br /> ELLE AMRESS LfiAD AGENCY PAT$ <br /> D r 2 E Bcr�cah f2io l4'4MFL4 <br /> 13P b�+ Wtt+R! (L4(017 l4--'to.c6 <br /> T r-{ 0 t4-14-wc m 't PAYMEE <br /> S�-y c(c tun 5�e t l 3 nom t-�rA-�L(K.1 FyC <br /> 0'L- 561,0 rukt- *t,4q 72.-12 w�7 (aA. MflY 2 r' <br /> 6 Qcfy-n ka[$-rr +t,i tat��c 73 73 w-os4 {.a,� -- ..,�� �nsIWI I <br /> W ES D Etit4 e.r ri 7 qOO w4S t- C H ��Ir. <br /> 013C> U1-1 D IAL <br /> THIS NOTICE IS SUBJECT TO THE "QUIREMENTS IDENTIFIED IN THE PUBLIC, HEALTH <br /> SERVICES/BNVIRONMENTAL HEALTH DIVIstot4(BHB)POLICY#02.001,ORDINANCE CODE OP SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)46$-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS"LEASE APPLICATION AND A NON-REFUNDABLE DEPOSIT OF$78.00 <br /> IS REQUIRED. DI?POSIT'S WILL BB RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE END. <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 PRI TO R13VIEWING THE <br /> DOCUMENT(S). , <br /> i. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECT'I?D BY THE Mt) STAFF AT THE EXPENSE OF THB APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO M APPLICANT FOIL PAYMENT. <br /> 6. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> . • SIGNATURE OF APPLICANT DATE �� 9 <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 12192) <br />