Laserfiche WebLink
( AN JOAQUIN COUNTY <br /> C IeuC HEALTH SERVICES t ` <br /> ENVTRONMEN'TAL HEALTH DrMI(5i <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> K I-C/,t/G67.DEJZ. <br /> APPLICANT k08 A II MA-2n d PHONE NO aO5 S <br /> aT0Cs - b� s <br /> ADDRESS ZF3 PHONE NO <br /> AGENCY NAME <br /> ADDRESS <br /> i <br /> FTLH ADDRESS I LEAD AGENCY DATE <br /> i <br /> .�vn 7 D l 1�11a r'c Ga <br /> 76 J5 T <br /> ED <br /> MAR <br /> SAN JOAQ6A COUNT <br /> RNWjfigTHjRV%y PUBLIC HEALTH <br /> THIS NOTICE IS SUBJECT TO THE REQ <br /> SERVICESIENVIRONMENTAL HEALTH DMSION(EFID)POLICY#92-007,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, SPATE WATM CODE, <br /> GOVERNMENT CODE AND THE EVD:)ENCE CODE. <br /> 1. A MAXIMUM OF TEN(10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FRES/RECORDS REi VIEW ARE BY APPOIIdT'MENT ONLY. APPOINTMaM ARE . <br /> ARRANGED BY CALLING (109)468-0340- OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THIRD 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 <br /> NON-RAFUNDABLE DEPOSIT OF$78.00 <br /> IF THE PR <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANTESlRECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD. <br /> REVIEW <br /> 4. HE ABOVE IDENED DEPOSIT IS <br /> y FEE <br /> ARDS <br /> THE BALANCE OF ,CHARGES ARE DUE TOW <br /> AND PAIYABLE PRIOR TOIREVIEWING THE <br /> DOCUMENT(S)- <br /> S, PUBLIC FILESMECORDS NOT RETURNED IN THE SAME CONDITION AS RECEVED 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. <br /> 6. ORIGINAL PUBLIC FRES I/LtECORDS SHALL NOT BE REMOVED FROM THE EHD PRE U <br /> SIGNATURE OF APPLICANT <br /> ---------------DATE 3 1Y � <br /> '� <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> \ EH 00 14 (REV 12/92) <br />