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7-07-1998 8=24AM FROM PACIFIC SACRAMENTO 916 858 2355 P_ 1 <br /> 0',—07-1?98 07'5 7PM FROM y%WWI TO 316$582355 P.02 <br /> SAN JOAQUIN COUNY <br /> T <br /> PuBI..1c HEALTH SERVICES 1 <br /> i ENV IRONPIR~4'.['N L HEALTH DIVI:SIQN <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APP ZCADNTTw jfa-.F.AF), Cjc^11 ) pliON$ NO <br /> ADDRESS— '����'' <br /> AGENCY NAME PHONE NO — <br /> ADDRESS g6;xq0, <br /> t#1rilif#b#R#Y####!#;71###z*##k#dritlr5t•#yfiltir#a111k�lttit.4##4#kt*!'*iktYtkfr##XINf <br /> }=t3�.T� ADURL►SS_ BUS IN}s.SS NAME-,L R M QR <br /> FACT -IT'( TYPF OF FILP <br /> -IU5 tPe ot-lem 41w4eat t slkx&mk& � 4 rzel6e ran= <br /> OFi <br /> I <br /> 11� <br /> #ttt}R#t*#t*it#iYtiW#it#33#'#tJrt##it!##YrYrtf►w#t:a�trs#t#ti+stir�t•iY.t#**-+s# <br /> IT-HIS IOTICE IS SUBJECT TO THE REOVIREMENTS 10E44TIFIl:D IN THE PUBLIC HEALTH <br /> SERV 1> ESIENV1RONMENUTAL HEALTH DIVISIONS IEHD) POLICY 194-007, ORDINANCE CODE OF <br /> SAN JpAQVIN COVNTY. eHO FEE AND SERVICE CHARGE RESOLU'i-IOmS. STATE WATER COOPS, <br /> GOVE�LAMENT CODE AND THE EVIDIENCE CODE. <br /> 1. A 1 AXIMVM OF 10 1101 PREMISE ADORE'SSE$ PER REQUEST <br /> 2. Pl18LIC FILESIRECORDS REVIEW IS BY APPIVTplgEI O�1LY. APPOINTMENTS ARE PROCESS- <br /> E-0 BYlCALLING 12091:168-3420. OFFICE HOURS FOR APPOINTWI+ITS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8.00 AM TO 12:00 NOON AND-1:00 TO 4.30 PM, <br /> 1 <br /> 3. A fiVRLIC FILESIRECORDS RELEASE APPLICATION JPRRA) IS REGUFRUD. <br /> i <br /> 4. PUklC FILESIRECORDS,NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY 171E EHD STAFF AT THE EXPENSE QF 7HE APPLICAW. TMS ADDITIONAL <br /> SERVILE WILL 8E BILLED TO THE APPLICANT FOR PAYMENT_ (SEE SHO POLICY 94-00k) <br /> S. ORf .INAI. PVSLIC FILESIRECORDS SHALL NOT 8E'REMOVEO FROM THL E140 PREMISE5. <br /> ................, ..........:.... .................................. <br /> $IOAIA URE OF APPLICANT / PATE 9 <br /> SIGNATURE OF RELEASIN FFICI 4 <br /> DATE <br /> CH 00 114 (REV 3196! <br /> i <br /> . i. <br /> f <br /> • TOTAL P.92 <br />