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09i?S/2CL'e 11:53 21394583"3 FIFTH F-DOR ` PAGE 02 <br /> ` SAN J'4AQ UIN COUN'T'Y <br /> PUBLIC RBALT14 SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT �/��/�ii�/��i1/Tf�L� �=1�.D 1 1: PROM NO <br /> ADDRESS II GOO 0'-4-e Wa ►-4- VTn <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> EUL.L. ADDRESS SUSINRSS NAME/ PROGRAM OR <br /> TYP8 Ota PTL13 <br /> 'rllepa2j- -e <br /> 7 7 cr` ss At< / Esc it <br /> 4--'L57_,0/ <br /> tw*k'iCtx**�r#ttirtic* k� Ytr+ 4r:F+w'1,we�}dr,F,4kFdF/rkyr*yt+kk}ttkyFwir'k'k**#t#f:t* k it*kt't`� <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS JOENTIFIED IN THE PUL'LIC HRALT'ri <br /> 5ERVIC>=S/ENV;R0NMrc-NTAL HEALTH DIVISION [E:-EDI POLICY #94-007, ORDINANCE COOS OF <br /> SAN JOACUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> . A MAXINIUM OFTEN L!10� PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILES186COROS REVIEW IS BY APPOIIVTMENTONLY. APPOINTMENTS AR= PROCESS- <br /> ED BY CALLING 12091468-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FnIOAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM_ <br /> 3. A PUBLIC FILES/RECORDS RELEASO APFUCATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FILES/REC0905 NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE. <br /> CORRECTED BY THE SHD STAFF AT TMr: EXPENSE OF THIP APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL IRE SILL,ED TO THE APPLICANT FOR PAYMENT_ {SEE EHD POLICY 94-0071 <br /> 5. ORIGINAL PUBLIC 1=1LES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> w..r...........r.+..r*.. r .• . .rrw.►..a.aa...a....... ..as�.�..: <br /> SIGNATURE OF APPLICANT <br /> T DAI ate` <br /> SIGNATURE OF RELEASING OFFICIAL � DATE <br /> EH 00 14 (REV 9196) <br /> Z0 39yd Ia3 tr�l9ZE9trLL IT ZZ 000Z/5Z/60 <br />