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SAN JOAQUIN COUNTY • <br /> . PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Te -1 / L I a } PxoNE No 16 366 /�o/ <br /> ADDRESS fc C; c <br /> AGENCY NAME--LLL <br /> PHONB NO <br /> ADDRESS <br /> FII ADDRE LEAD AGf CY DATE <br /> Ld '7C Qcci �rc 02. �'av,v�� <br /> rr_ <br /> Cfl4N� CE-- - <br /> 2 � 199 <br /> �l.� l nclFi ✓-U�.� ,o�.,r-�� (L err <br /> �o c' C i Y1�v�_ A <br /> s� a <br /> LjLH�LTHS vltis <br /> Ei., r_'r i I�y2, ourt�-tl <br /> ENVIRONMENTAL - <br /> l65 C; cdLN Cd,A -v - �� <br /> 0. <br /> 2 I A <br /> a �� <br /> 412 ; S' /-G 0014 <br /> I <br /> THIS NOTICE IS SUBi Cr TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALT <br /> SERVICESfEN-; RONMENTAL HEALTH DIVISION(ERD)POLICY#92-007,ORDINANCE CODE OF SANH <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE ..�ND THE EVIDENCE CODE. <br /> 1. PUBLIC FII.ES/RECORDS REVIEW ARE BY eL NT ONl-Y. APPOIIJIhiENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOIN'T'MENTS ARE SCHEDULED <br /> MONDAY TSU FRIDAYEXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 00 <br /> 2. A PUBLIC REC . <br /> ORDS RELEASE APPLICATION AND A NON RFF[JNDABLE DEPOSIT OF $78 <br /> IS REQUIRED. DEPO'SPi�I'S' WILL BE RETURNED TO THE APPLICANT IF THE FMES/RECORDS ARE <br /> NOT AVAILABLE Wtititty THE CUSTODY OF THE EHD• <br /> 3. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BAI.A2jCE OF THE CHARGES ARE DUE AND PAYABLE PRIOg TO REVIEWING THE <br /> DOCUMENT(S). 1- <br /> 4 PUBLIC FII Eg/AECORDS NOT RETURNED IN 1 SAME CONDITION AS RECII`'ED WILL BE <br /> CORRECTED BY TIIEI,EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WD..L BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> S. ORIGINAL PUBLIC FnmiRECORDS NOT BE REMOVED FROM THE EIID PREM;SES• <br /> SIGNATURE OF APPLI ANT — DATE Z <br /> SIGNATURE OF RELE SING OFFICIAL DATE E34 00 14 (REV 10/92) <br /> I 'd LC : II 36i0Ci01 WOd� <br />