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10/06/98 TUE 16:07 FAX 2094671118 AGE—STOCKTON uj <br /> of GLiuvrvo-vi <br /> � SAKI J4AQUIlN COUNTY � . <br /> PUBLIC HEALTH SERVICES 90 — �z <br /> ENYIROM EsNTAL HEALTH DSYLSION <br /> PUBLIC RECORD RELEASE APPLICATION <br /> -VsUZa ni4eo o_rso n J <br /> APPLICANT uQ n E n m PHONE NO lD g- 7`1��l_f9Q4 <br /> ADDRESS r 1 <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> FILE ADDRESS LEAD A fiNCY DATE <br /> 500 S,cl,morrSir <br /> L 1l <br /> 3k3r7-sp . tir <br /> �►��r _ In).- le <br /> 4004 G EL Nm&Ab <br /> 3 143 d <br /> 1 t <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICESIENVIRONMENTAL HEALTH DIVISION(EHD)POLICY x'92-007,ORDINANCE CODE OF SAM <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIhjU16i OF TEN(10)PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILESIRECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (04)468-0340. 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.a,1. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUNDABLE DEPOSIT OF$78.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE 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 PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> S. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY 714E 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 MECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT DATE _Z — <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 I4 (REV 12/92) <br />