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SAN JOAQULN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL DEALT$ DIVISION PUBLIC RECORDS RELEASE APPLICATION APPUCArr ADDRP(��S . .� PROM NO S9.0-07 7-77 ,- �nlF.QFti.oCE .0 oA� 2.CG.'i n4 Ltd ::'G�•{ 7oE /s. AGENCY NAMEY~.,�T�� ov�y -,y s ,/�"N� PHONE NO ADDRESS a 3-y o c.e 7 0^/ c-,q q Z o PAYMENT i�I: $ ADDRESS LEAD AGENCY ' R:+.ST.4C. c,GE'A 'J/) %l;�'r?��? _:.q,./ .d.vc�✓i.✓�ovn/J'`'1''' I�il4C �� ;� �� - c EN!V1R©NMEMTAL HEALTH ..u,o s c �.v E`/!Q o L�7- s�,,,./ Tc.s�✓l ✓ carr ' 4 „ y AA V.<,/ ��2 E.✓ �'T �//s J mss✓,o THIS NOTICE IS SU=CT TO THE REQUIREMENTS mo-rI F'IED IN THE PUBLIC HEALTH s�RVICES/ENVIRONMENTALHEALTH DIVISION(EFIC9 POLICY X1'92-007,ORDINANCE CODE OF SAN 30AQUIN '`?LINTY, EKD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, :�DVERNMENT CODE AND THE EVIDENCE CODE. i. A MA)aMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. PURUC FII-ES/RECORDS REVIEW ARE By AMM fN'PMFyr ONLY. APPOIN-rMENV'TS A ARRANGED BY CALUNG (209)468-0340. OFFICE HOURS FOR APPOR4TMENTS ARE SCHED'L. -• ',:ONDAY THRU FRIDAY EXCLUDING HOLIDAYS, S:OG A.M. TO 12:00 NOON AND 1:00 P.M,. TO 4: A PUBLIC RECORDS RELEASE APPLICATION AND A NQN.REFIJITDAT3T�DfipOSIT OF S; i�OUIRED. DEPOSITS F-7117, 13- R i v,RNvED TO TE? ' APP:.ICAN-': IF THIS FILES/RECORDS ARE AVAILABLE WIT)-HN Z-E CUSTODY OF THE ExiD. 4. THE ABOVE IDENTIFIED DEPOSIT IS APPUED TOWARDS ',HE TOTAL FrLX F VTEW Fr—z' ;-71ARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING -- PUBLIC FIL F-S/RECORDS NOT RETURNED IN T-HE SAME CONDITION AS RECEIVED WILL Bi: -aECTED BY THE EHD STAT-P AT THE EXTENSE OF THE A.PPIICANT. MS ADDMONAL SEP t;CE R'II.L BE BILLS TO"ME APPLICANT MR PAYMz?v;. g..�.. �: �'- ORIGINAL PUBUC FILES/RECORDS SHALL NOT BE REMOVED FROM THE QjD PRF-lv,IS . ' i'-;NATURE OFA . 1_ _ t... PPLICAh�. �.,_�- -_ , ��-; -� - -�_.--, DATE �s •- � �. - . .TNATURE OF RELEASING OMCIAL DATE . ':�' 00 14 (REV 12/92)