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• - JVL'''tlOs`1b L L FY1 -I t•IL . . - - -•- __ -_ _ <br /> ••.ate <br /> 05-22-1 m 81 s mw Rd9 m 14159229363 P.W ` <br /> t . <br /> i <br /> SAN JOAQOTN COUNTY <br /> j PUSLIc H1rAtTu aawicss <br /> 6NVIRONmorrAL HEALTH DWISION <br /> PU8LId R=RW kELBA9B- APPLICATION <br /> AiPPLICAM' Su,rnrri s1 r pis Na s_� gZz-�13-3s <br /> AMMS <br /> AiGR&= NAM_M _ -- HONE no <br /> ADDR"S _.... _.. ... .. <br /> rt,*ria.as:trtittrtRtritt:titittt+►.a•aaittt4itttt.riri♦•ar.aaNtaA#iit*at <br /> PULL AWRZC& BLISiNb;.S-x'1.1 L (X'RAM nR <br /> EACILLTY <br /> I TfPH OF FIDS <br /> fill KIM- A L&'&61 N e <br /> Jit <br /> •i►ii4ttiAi•+rft+++tt•rrttYw+tRw:A■+3ttw• AA tAtR#+♦*t aa+.�++tafraia+ii•r,At <br /> THIS NOTICE IS 8U6.Ificr 10 THE REGUIREOA"t:NTS IIXNTIFIEn IN THE PUBLIC HEALTH <br /> 3MV#Cn1ENVIF10"MRNTAL FIBALTH 000319N ►BHOI POLICY 0994.007, OWMANCE COOP OF <br /> SAN JOJKOUIN COUNTY, EI ID FCC AND SERVICE CHARGE Rh$OL ITIONS. STATE WATER CODE. <br /> GOVEANMENT 00139 AND THE EV-Ott-ICP CGDE, <br /> 1. A MAXIMLIIN Or IM IM PREMISE ADDRESSES PER REQUEST <br /> z. PUM IC K1113M ECORGS REVIEW 13 BY WMWMWT GN1.APPOI n ENTS ARE PROC"S- <br /> ED <3Y CALLINC 1201198-3429.OPFICtr HOVRV!<OR AHH0INTMw4TS ARE SCHFOULIED MONDAY <br /> THRU MDAY EXCLUON G W)LIDAYS. 8.00 AM TO 17-00 NOON AND 1;00 TO 4:30 PM. <br /> 3,. A PUBLIC FLEE/RSCbROS RELEASE APPLICAYtON IPRRA3IS M1fQU1RED. <br /> 4. PUa1C FILEMECORDS NOT RETl/ 4WD IN THE SAME CONDITION AS REClIVIV WIU. dl: <br /> COARKYRD BY THN EHb STAPP AT THt E7CMNS8 OF THe APPLICANT. THIS Ad11i110NA1. <br /> dERVICE WILL 09 BILLED TO THE APPLICANT ICOR PAYMENT. (M CHO POLICY 94. 047) <br /> S. CMIGWAL PU$UC FILESIRECORDS SHAD NOT BE REMOVED FRpM THE EHD PREMISES. <br /> S►GNATUIiE OF APPLICANT. DATfi <br /> SIGNATURE OF RELEASING OFFICIAL DATI <br /> ESI 00 14 (REV W9181 <br /> TOTPL P.02 <br />