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SAN ,T O h Q UIN CO UN-n T , <br /> PUBLIC HEALTH SERVICUS <br /> E.N, VMQNrNM-N I'AL MALM D1VISIVN <br /> Pi1Rl,1C lllrC:ORT)S RELEASE A UCAMN F'U' <br /> Al�l'21rANr�-�!�"e G�'Z PRVIvH <br /> ADDRESS v _ <br /> ACSNCY NA;1fI3 PHONE NO �.-sr-� <br /> ,MDRESS__ <br /> LEAD AUNC-1 <br /> a 6p -- <br /> F47L <br /> - <br /> IWS NOTICE IS SUBJTCT TO Toll TO-QUIRI(MIIN f5 1OP-N-11-FLED IN THE PLrBL.1C HEALTH <br /> SERVICESTN`,rMONN L"'RAT.T1T T)I%TSI()N (LHL))Pf.1LIC Y PV7.0-M, ORDLNA.NCE CODE OF SAN <br /> JOAQLTIN COUNTY, FS AN-T) CritV1c.F1 t.:HARGE F-PSOL1 TIONS, STATE WAT'HR CODE, <br /> GOVISRNMENT TIDE <br /> 1. t OF T'T:N (Ifj) 1'K1✓AUSE ADDF.ESSBS PER REQUEST. <br /> 2. C TTTPSlklr.c��u��v FEVIEw .ARE B1" AUQIIrTIaS-T--Q-lLY. 16SPO11s'"I►•i$fTS ARE <br /> ARRAN b BY CA1_I,TNn ;71N)46g-I'14o. omcE HOURS PCXR APPOINTMENTS ARE SrNEbLriBD <br /> MONDAY T1iRU FAITIAY PX,:Lt-01NU lff�LLDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P,M, T04:30 <br /> P.M. <br /> ?. A I'1 PUt 'RFJ'ORDS RFL EASE APPLICATION ANLL A NQN-REFVNUA DI;POSTT OF, 09-w <br /> I� Rp"ULRFD. DcrnsTTS WILL BE F=TP,,NSD 10 71TE APPLICANT IP T7T1; tll-E RECORDS ARE <br /> NOT AI'MI-ABLE R1THIN TI4E CUSTODY OF THE END. <br /> 4. T 1F A90VE 1DENTIFTFD DEPOSIT IS APPI!T,.0 T(JWAkllS THE TOTAL FILE REVIEW FSR <br /> CI{AR(3$, T3JE BALANCE OF 7142 CMARCP.S APR L)I-!b AND FAYABLE L TO REVIER'INO THfl <br /> bcC1J1•iBNTtS). <br /> S, P'JBLTC FTLP-S-�Rrt:i,RDS N(JI'R-61I I tNEO IN THE SAID CONDITION AS RBCMVED W'ILLBB <br /> CORRT:CTFT) Tiy THE 0VW STAFF AT THE EXPENSE OF 'TNE APPLICANr'T. 7"8 ADT4TT7ONAL <br /> SF.R\'1('T: WILL NB BILLED TO THE APPLICANT FOR PA5'MENT. <br /> F�. QR1(3lN;.L.FLUBUC FIj S,7ZCOPDS SAALL NOT Bp fiEMOVFJ) >RI rM THE EHD PRE-KUSES. <br /> S10NATURE OF APPLICANT —_ — DATE G�s 902 <br /> SIGNATURE OF RELEASTNG OFFICIAL —_ DATE <br /> P-H 00 14 (RI?v I2+92) <br />