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Po-,14r Fax Note 071 �'m" 2 4 w�oa� / <br /> �e p• .iYc±J From CA.�7lYR6�D <br /> ep1. co. ,(r�°A?sFr/ A566-- - <br /> PhQ�t <br /> Fex Y(20'1) Fat t q/Io 'vi'�' <br /> SAN JOAQU- 1- 2 u t� <br /> PUBLIC HEALTH SERVICES � () P, � S!- <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUALTC RECORDS RELEASE APPLICATION <br /> �) r —_PHONE NO W& ZaU -ZZOU <br /> APPLICANL'.eq Ju --n <br /> AhDPESS /-2-S .�'n2�tp.ACGL._- c <br /> YHONS NO <br /> ACENCY NAME jerV.2rtr0 9`-.A` <br /> ADDRESS <br /> PPOGPIIM OR <br /> [TLI,�L�UP3S9 BiL INE .—N1�t413L TAPE 0OF FILE <br /> FAl'TLT1 <br /> 1 f3 ZO n/ iYlAc <br /> n_x>-.. <br /> SB/ E. /ttA�ffi s =y <br /> 26 {F e.l.cel>v f62L7E�H.•J� <br /> CJS �l. l =ty ---vne/ecc,Pwrcr 1JK f. <br /> t1 ♦ Itt ttf k-0t � ttkt # kttt # kt#t#tk4+t####t###t##ka##ki#####'t*####*### <br /> THIS PJOTICF IS SIJPJFCT TO THE 11EQUIHEMEN'TS IDENTIFIED IN THE PUBLIC HEALTH <br /> SFRVICFS/FNVIRONMFNTAI. HEALTH DIVISION (FHDI POLICY 694-007, ORDINANCE CODE OF <br /> SAN JOAOUIN COUNTY, EHO FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE. <br /> GOVFRNMEN-I- COUE AND IHE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN — PREMISE ADDRESSES PER REQUEST <br /> 7.. POINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> PUBLIC FILESlRECORDS REVIEW IS BY AP <br /> ED BY CALLING 1209146E-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, B:t)O AM TO 17:o0 PIOON AND 1:00 TO 4:30 PM. <br /> 3. A PUBLIC FILES/RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FILES/RECORDS NOT RF I URNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED Y THE EHD STAFF AT SERVICE WILL BE BILLED O THE APPLICANT FOR PAYMENTE EXPENSE OF I HE P SEF FHD POL ICY 9CANT, THIS 04` 007 AL <br /> 5. ORIGINAL PUBLIC FILESIRECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> .t 1 <br /> ...................#......... <br /> SIGNATURE OF APPLICANT <br /> UATE�rZ,3=_Lt'L__ <br /> SIGMA f URF OF RELEASING OFFICIAL <br /> DATE <br /> EH 00 14 IREV 9196) <br /> 111101- F.01 <br /> �L �AR <br />