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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES a <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT E411[PAe M A! M //, ' _PHONE NO ,f/-) �P-cf_r— Y93 y <br /> ADDRESS Z6 ✓•' // c s CA 4fY 7 <br /> AGENCY NAME HONE NO <br /> ADDRESS <br /> FULL ADDRESS BUSINESS NAME/ PROGRAM OR <br /> FACILITY TYPE OF FILE <br /> / Y63U Yl;0 �L <br /> 2Y uU F/n'4 r-r <br /> ]ry I d rz-/ Ouro da tel' lfw­h (�rp v,u• 5n., fin.•., �� � GZL U1-7v 17-"4111 <br /> 3E lZ <br /> Y_ 1S )- cz /I, r�/�, ct irr.�N u,�, J<_j'jj/„ E41 ZL-Aj 2J60 0!7Ta i13 1,!9JC <br /> Ik�7 jo S (Z L. Ou,1 q tin <br /> `i'b+� '4�1' FrI11z,n r:►-«••4 C�Mr/ ljn: �cc {L �{t g-41 it <br /> � �r ,. � '� �rcti� l_�r+� Jvv ("h-'✓h �uC( l ; lL-:l•S4 2ICY 5610 2���i C C <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) POLICY #94-007, ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1 . A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST <br /> s - <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING (209)468-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> 3. A_PUBLIC FILES/RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> 4. :PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 007) <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> i 4 4 4 i i i 4 4 4 4+4+4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4+4+4 4 4 4 4 4 4 4 4+4+4+4 i i i 4 4 4 4 4++4+4 4 4 4 4 1 4 4 4 4 4 <br /> SIGNATURE OF APPLICANT DATE 3/6 1y-7 <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 9/96) <br />