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IL <br /> • SAN JOAQUIN COUNTY • <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEAL'T'H DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> n ' �y.� <br /> APPLICANT / II E� 4. p�.� � ` ��0'yi> PHONE NO (c1/6 7P- Z// <br /> ADDRESS /OJy /NE/oc Ix Ca„z -( i4b t1NCL14: CA `5-16 Jd' <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> FILE ADDRESS LEAD AGENCY DATE <br /> 17 <br /> I'Ylln, Nd 4Wt�,,11607-1 Alf <br /> U/rte s/a fro. x - <br /> / C J ,C <br /> SG e 4 7 91 u Luu)ee S 6FUM <br /> shell 613�/ Y _ Stkf,, . �o�^ <br /> i.Ify lti� -1t, 7,zk3 PlIclki Avf S/k&�.. <br /> Qreuner3-'x L 7b u(jl, <br /> uiti.cyal f; Ll Gc„C / . <br /> ara,n o., 7 .3) <br /> cd,)r•ptr <br /> THIS NOTICE 1S SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVHRONMENTALHEALTH DIVISION(EHD) POLICY#92-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)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.M. <br /> 2. 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 /> 3. 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 /> 4. PUBLIC FILES/RECORDS 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 /> S. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT Cp DATE Il I 7- �L <br /> IV <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 10/92) <br /> G3� <br />