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. ' SAN JOAQUIN COUNTY <br /> s <br /> PUBLIC HEALTH SERVICES(l <br /> ENVMONMENTAL IMALTH D ION <br /> PUBLIC RECORDS RELEASE AP ICATION <br /> APPLICANT PHONE NO 12 3-1[ <br /> ADDRESS 25 2-71 .k S S l-y.�-i ..e .S vt,� c 7 <br /> AGENCY NAME `Tw,t , L � S- PHONE 7 a z 1 <br /> i <br /> AMP= <br /> E <br /> I <br /> w <br /> ELLE AMMS .BAD AGENCY DATB <br /> >k�n.t -2 Lsie 3&acpki 1210 1414KAMOK - <br /> l�L <br /> Bp C)"1 w I+,R r I L(b q f4ua o cz , <br /> yp RENT <br /> :Few Q �i O 14�wtM <br /> Stoc_14 Fo St-et{ 3no- <br /> Q L(L S{-' A4kt *t.4q ?L72 we'r (A rut MAY 2 rs1993 <br /> �p _<xb&fjM kaiS-vrr, ((4 1AL-c .7373 1.4.I,0.St {[x,� ow GOUNT <br /> wES L47gOO LIJ45,• ( M I►L3 ;� <br /> LTV10 L�L6<_ 3 i.2 '1_I '17 U-)LA t ta.� F[�t11R0_fVMENjAt <br /> THIS NOTICE 19 SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH } <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION(HR13)POLICY#92-OW,OPM114ANCB CODE Op SAN <br /> JOAQUIN COUNTY, RHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVMNM13NT CODE AND THE EVIDENCE CODE. r <br /> 1. A MAXIMUM OF,,TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY AMIMUM1 ONLY, APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)469-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 9:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A t.ON-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 THI3 EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE.OP THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> 5. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORREMD BY THE MID STAFF AT THB EXPENSE OF THE APPLICANT. THIS ADDI'T'IONAL <br /> SERVICE WILL 1313 BILLED TO THE,APPLICANT ICOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FILM/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> I. <br /> SIGNATURE OF APPLICANT DATE ��_-7,z 9 —:k- <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 12192) <br /> - - <br />