Laserfiche WebLink
• SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES gy <br /> ENVIROMIENTAL HEALTH DIVISION <br /> PUBLIC RECORDP RELEASE APPLICATION <br /> I en Q.rso r� <br /> APPLICANT Em a I ry n mtew b PHONE. NO A&q- <br /> ADDRESS , <br /> AGENCY NAMB = PHONE NO <br /> ADDRESS <br /> FILE ADDRESS LEAD AGFt= DATE <br /> � r <br /> 3LI30 45 -EL. Wwo <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVTCES/ENVIRONMENTAL HEALTH DIVISION(EHD)POLICY#92-007,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I. A MAXIMUM OF TEN(10)PREMISfi ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY AMINTMENT ONLY, APPOINTMENTS ARE <br /> ARRANGED BY CALLING (201 468AGQ. OFFICE 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 /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-RFOUNDABLE DEPOSIT OF$78.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLLCANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE W1TMN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> S. PUBLIC FII.WRECORDS NOT RETURNED IN THE SAME CONDITION AS RECIIVED WILL BE <br /> CORRECTED BY THB EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WIl-L BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> t 6. ORIGINAL PUBLIC FIL.ESMECORDS SHALI.NOT BE REMOVED FROM THE EHD PREMISES. <br /> I <br /> SIGNATURE OF APPLICANT DATE <br /> SIGNATURE OF RELEASING OFFI AL DATE <br /> 1 EH 00 14(REV 12M) <br />