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• SAN JOAQUIN COUNTY ` PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION PUBLIC RECORDS RELEASE APPLICATION APPLICANT 5rluv\ C)n+ OV PHONE NO Zo9 `176 1635 ADDRESS AGENCY NAME Lc. PHONE NO ADDRESS 83 / arr/( GN_ S0,14P. 6Z . S±'eokfonTCA 95ZO7 FILE ADDRESS LEAD AGENCY DATE I IGc/�) AVenue EN Sl�f� S�q�lo✓1 1 GC', 'G AVP,VIt>'2 N1� C on -cats US �✓' �/✓ MAD. a U ^^4 SAN JOA0111LCUUI;ry I Fy4(lr 61 Ai_TH Ce4s:!CCS ENVIISUiNIALNIA�Hlj, iH RlyiclON THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH DIVISION (END)POLICY#92-007, ORDINANCE CODE OF SAN JOAQUIN COUNTY, END FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, GOVERNMENT CODE AND THE EVIDENCE CODE. 1. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. 2. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 P.M. 3. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUNDABLE DEPOSIT OF$78.00 IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE NOT AVAILABLE WITHIN THE CUSTODY OF THE END. 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE DOCUMENT(S). 5 PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE CORRECTED BY THE END STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. 6. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE END PREMISES. SIGNATURE OF APPLICANT - DATE 3 2e 9 SIGNATURE OF RELEASING OFFICIAL DATE EH 00 14 (REV 12/92)