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SAN JOAQV N COUNTY <br /> •' PUBLIC HEALtg SERVICES <br /> ENVtRONMEN'TAL HEAtTll 13MSIOM � <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT MATT NO L D PHONE NO <br /> AbbMS <br /> AOENCY NAME p A RK E R r=-N V 1 R©N M E MA L PHONE NO q-39- 102 H <br /> AbDRBSS,_ u 5 CZ I A LTC2 C-T, P i TTrS_B U R C-, q 4 SSS <br /> FILA ADDRESS : . LEAD AMQX DAT' <br /> 14o L LY .DRI VE- <br /> .3 RAN LINE i <br /> f S 1 d LINE. <br /> . . 27 5 EAST- GRANT LtIVF_ Lot' _ F <br /> QQ <br /> a �.Frnt'i41 1 <br /> �NV1R0 1T 1 SERVICES <br /> THIS NOTtCI3 IS SUBJECT TO THE AEQta9&lENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICESIENVIRoNMENTAL HEALTH DIVISION(EM)POLICY#92-001,ORDINANCE CODE OF SAN <br /> IOAQUIN COUNTY, MD PM99 AND SERVICE CHAILGE RFSOL.UTIONS, STATE WATER CODE. <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> �i. A MAXIMUM o�T13N �iaj�ItEMfsE ADDRESSES PI7t itBQUbsT. <br /> 2. PUBLIC PILLIS/RPiCORD$ REVIEW ARE $Y AIEoINTMBNT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLINU (200)46W40. OPMCI3 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 /> J. A PUBLIC RECORDS RELEASE APPLICATION AND A ICON-BEFUNpABLB DEPOSIT OF$78.00 <br /> IS REgmtEb. DEPOSITS WII L IIs RRTUANED To THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN.THE CUSTODY OF THE E14D. <br /> • I <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE Or THE CHARGES ARE DUE AND PAYABLE PRIOR To REVIEWING THE <br /> F <br /> I <br /> S. PUBLIC P=/RECORDS NOT RBFI'IJRNED IN TH13 SAME CONDITION AS RECEIVED WILL BE <br /> CORMCM BY THE Mb STAPH AT THE IMPENSE OP THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL.BE BILLED TO"M APPLICANT MR PAYMENT, <br /> 6. .=GINAL PUBLIC ML 2SIRECoRDS SHALL NOT 913 REMOVED FROM THE EHD PREMISES. } <br /> ` SIGNATURE OF APPLICANT DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 12/92) i" <br /> . k <br /> ------------------- <br /> I <br />