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SAN JOAQUIN COUNTY <br /> " PUBLIC HEALTH SERVICES -�_,r <br /> ENVIRONWNI'AL HEALTH DIVISION <br /> i <br /> P I LIC RECORDS RELEASE APPLICATION I, <br /> 1.�N �[ 11 '- 1 , PHONE NO <br /> APPi.ICANT. . .--,Y c� <br /> ADDRESS <br /> AGENCY NAME. �C 4c:�.. cC_ �. , C . PHONE N4 <br /> ADDRESS € <br /> EI <br /> E <br /> FIL>r ADDEMS 1 FAD AGENN�Y_ i <br /> ��7 Sr J T.1'CV 5T R.}F3�. p�P-.K. ' _.. n•1�rel >~C''n <br /> 1[J0.2 L uArpK�� 1L� <br /> -5 ver <br /> c i''r+ A M'� r lc� - D '' t� o <br /> .r."C, rtit tJ <br /> -- <br /> - <br /> - VIA] <br /> �-1 r�Ds�r� r� �.r�,����� , <br /> m 5p_ 2� LL <br /> _ZnE ><. II t3 #Z as, ��n]5�rt-�'r i� �� � n•��1i`zl��"T .sem: <br /> c-rvlrJ F�ovS (:"q5U <br /> ` - <br /> � �-rE rv�t rile.. -"vr' gra `!24 1 <br /> uNTS IDENTIFIED IN THE PUBLIC HEALTH � <br /> THIS NOTICE IS CT TO THE REQ EORDINANCE CODE OF SAN <br /> SERVICESfENVIRONMENTAL HEALTH DMSION(IIID)POLICY 1192-007, <br /> STATE WATER COL; 1, <br /> JOAQUIN COUNTY, IID FEES AND SERVICE 1FCHARGE RESOLUTIONS, J <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> k NT OM C• J APPOWTMENTS ARE <br /> 1. PUBLIC FILES CORDS REv1>;w ARE BY �IN'� <br /> ARRANGED BY C G (209)468.4340• OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRID EXCLUDING HOLIDAYS, 8:00 A.M.TO 12:00 NOON'AND 1:00 P.M. TO 4:30 i <br /> h <br /> 2.P.M. A PUBLIC <br /> RECORDS RELEASE ApPUCATION AND A - D DEPOSIT OF 578.00 <br /> IS REQUUtED. DEPOSITS WILL BE RETURNED jTO THE APPLICANT IF THE FU-F-S/RECORDS ARE <br /> NOT AVAILABLE WM IN THE CUSTODY OF THE MID- <br /> 3. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS TILS TOTAL FILE REVIEW FEE <br /> �pRGE. ��TLHE B CE OF THE CHARGES ARE DUE AND PAYABLE PRIOg TO REVIEWING THE <br /> DOCiJMENT{S). <br /> 4. PUBLIC FII.ES CORDS NOT REPURNED IN THE SAME CONDITION AS RECEIVED WILY. <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT.', THIS ADDITIONAL <br /> SERVICE*U-L BE BMLED TO"ITIS APPLICANT;FOR PAYMENT. <br /> S. ORIGINAL PUB C F7LES/RECORDS SHALL NOT BE REMOVED FROM-,'THE <br /> F ID PR NOSES. <br /> SIGNATURE OF APPLICANT �- C F � DATE <br /> ii <br /> SIGNATURE OF RELE SING OFFICIAL . DATE <br /> EH 00 14'(REV 10192) <br /> �,7- i y <br /> q <br /> WOE <br /> I! I d '} ZE . I 1 26/06/01 <br />