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SAN JOAQUIN COUNTY <br /> 1"3LIC xEALTFl SERVICES <br /> E'T"IONI•RTNTAL TIEA.LTH DrMION <br /> PUBLIC RECORDS RELEASE ,APPLICATION <br /> Appz zCArrr '�' [ .� PHONE NQ(,�9�5,` ) -�r17 f <br /> ' <br /> ADDRASS 'l t' 1' r` Il: <br /> AGENCY NAME u =-��T -'� ..Ti-� ? � ,-- � - _ �i . PHONE NO � 9n4yZ e <br /> ADDREa-3_ <br /> Ad F7, <br /> AI)DRESS LAD AGENCYp�,Tg <br /> ,CtI / <br /> 1rTUS NOTICE Is SLWECT To THE REQUIREMENTS IDENTIFIED IN .TIR-. WOUC HRA.LTH' <br /> SFRVICBS/ENVlRONMENTALHEALTH DIVISION(l_HD)POLICY#92.007.ORDINANC13CODB dF SAN Y ;i,,'' <br /> JOAQUIN COUNTY, ERD ISS AND SERVICE CHARGE RRSOL.UTIONS, STATS`WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. - <br /> 1. A MAXU"OF TEN (10) PREMISE ADDRESSES PER REQLFFST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY APMNTMtsNTs. <br /> ONLY.,. ..APPOINTMENTS An, 4 <br /> ARRANGED BY CALLING 8-0340. ONCE HOURS FOR APPOINTMBM. ARB S`CXIRI3LYtw <br /> MONDAY THRU FRIDAY OCCLUDING HOLIDAYS, 8:00 A.M. TO 12--00 NOON`-A j-.bb P.M.TOA 3o.'.' <br /> 3. A PUBLIC RECORDS RELEASE APPUCATION AND A NOK-9 U ,HLBDMOOSI'T OF S78-ODL,4oii <br /> IS REQUIRED. DEPOSITS WILL BE REIVRNED TO THE APPLICANT IF THE FILBS/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUS'T'ODY OF THE EI•ID. <br /> t <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE j <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE TO REVIEWING TM <br /> ' /�.'(S)• <br /> PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDI'T'ION AS RECEIVED WILL BE <br /> CORRECTED BY THE EEM STAFF AT THfi EXPENSE OF THE APPLICANT, THIS'ADtJI'IIONAL' <br /> SERVICE WILT.BE BILLED TO THE APPLICANT FOR PAYMENT. :" :5:± <br /> ., 6.- ORIGINAL PUBLIC FTLES/RECORDS SHALL NOT BE REMOVED FROM THE ERD FR.EMISES. <br /> SIGNATURE OF APPLICANT ti:.a•- i. DATE I I Z <br /> SIGNATURE OF RELEASING OFF[CCAL__– DATE <br /> LH 00 14 (REV 12192) <br /> ;70,d ZbSi T S S i r.r W08=1 wusz:T �6b i-9Z-80" <br />