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# 97Ty SAN JOAQUIN COUNT PUBLIC ITE'ALTH SERVICES ENVIRONMENTAL HEALTH DIVISION PUUBLIC RECORDS RELEASE APPLICATION ! APPf�ICANT tau,44 ~�Y PTIONE NO 0:7/Ci}`l�c�- nnl7tzE�s Co��/F ori l,5r�r�ry 'TfV i, e-4 --- i�CEA�C'f NAME �5 !/U�- PHONE NO 'SIO Coc7-� AL)DRSSS ---- --- - i r . v ♦ ki•4 *+ 4 *##* i 4 A * t # k#•f#' ♦ 4 • 4 # i F 4 t My#t#+►4## #t+ BUS ^r NAFRE PT?OGIZAch`OR �--L 'TYPE UE' FILE F71C:ILIT._ NA13 JVa /v �or� Pcr.S_ �y 5T i t r 1 �1 a ,v _ ✓� a +� e �aees�:,� 1 J T Ir � ►- 1. S ��cl Lus-rlL fry►'tX f �r S �A.fLOvl S bttQt i+ ¢ c �o( Thr c'&k S -- 121�1 I�(1�Slt_.i�lrt�rt<SfYre# N AA 1,40ePicnSof rl) YPL lea NI- 17��'f✓� r--�-- ' e s ar p. .S T— L A, # * 4 #* *#*##**+#*##* k *# #* ** * 4 4 k k * 1,-k k F#+#** k#***** * I'FI15 MO�'ICF IS S1,JB,JF_CT TO THE REOUIFIEMENTS IDENTIFIED IN THE PUBLIC HEALTH SERVICES/ENVIRONMENTAL I ICALTH DIVISION [EH01 POLICY a94-007, ORDINANCE CODE OF SAN JOAOUIN COUNTY, END FEE AND SERVICE_ CHARGE RESOLUTIONS, STATE WATFR CODE. tlo%/FRNMENT CODE AND THE EVIDENCE CODE. 1 , A MAXIMUM OF IFN j101 PREMISE Al)DnESSES PER REULIESI 7. PUBLIC FILESIRECORDS nEVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS- r-O 13Y CAI I INE, (-;109146H-3420- OrriCE HOU"S FOR APPOINTMENTS ARE SCHEDULED MONDAY I'14RU FRIDAY FXCLUDING HOLIDAYS, 8:00 AMTO 12:00 NOON AND 1:00 TO 4:30 Pert. T A PUBLIC. FILES1RFCORDS RELEASE APPLICATION (PFIRA) M REQUIRED. J. PUBLIC FILESIRECOQDS r'JOT RETURNED IN IIIF- SAME CONDITION AS RECEIVED WILL BE r.:oRHFCTED BY THE EHD STAFF AT THE FXPFNSR: OF THE APPLICANT. TIII$ ADDITIONAR_ SERVICE WILL BE BILLED TO FHE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94 007) 5. ORIGINAL PUBLIC FILE' I19ECORDS SHALL MOT BE REMOVED FROM THE GNI, PREMISES. .. . . . ...... ... . ..... . ...... ........L .. ... ...• .. ........ .. ...... SIGNA TUNE OF APPLICANT (�Q!!-//�1G,� �QDATE � - SIGNATURE OF RFI.FASING OFFICIAL_ DATE F I� 00 I A IRCV 91961