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APR-20-98 13:05 From: Tetra T an Francisco 4159745914 T-595 P.02/02 Job-687 <br /> SAN JOAQUIN COUNW <br /> i PUBLIC HEALTH SERVICES <br /> ENVTRONMrNTAL HEALTH DIMS YON <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APP' ICANT �h LPx�¢Ltry� 0 <br /> ¢y <br /> DRESS 1 way PHONE NO �K�C) `ltZ 1 (`(t `? y•�Sq�y <br /> Z- c c- <br /> AGEICY NAME j cd-�� PHONE NO <br /> ADD 8SS <br /> i <br /> I <br /> w#,�.�.Ft,rr#�#tet�tirrit� rtt*fit#*iikiitittr#ttit�t#irttt r *;tt*t#*#�#*t* <br /> I <br /> FU , ADUR>~ss BAUSINES9 NAME/ kRQGRAM OR <br /> ZtiA 1�,.i,K S�. E a,t C, " <br /> �i <br /> ._YS7N �,1 o r-�1;.. Iy �F'..�:►4►a,n -�. Ga...�d.,.� _�uxT�' <br /> I <br /> i <br /> THISOTICIE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> Si;RVI EWENVIRONMILNTAL HEALTH DIVISION (END) POLICY #94-007. ( DINAIVCE CODE OF <br /> SAN ;OAOUIN COUNTY, END FEE AND SERVICE CHAFtG'- RESOLUTIONS. STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE_ <br /> I_ s>IMAxIMUM OF TSE LLp� PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILES/RECORnS REVIEW IS BY APpQINTMENT QNLY. APPOINTMENTS ARE PROCESS- <br /> ED B� CALUNG f2091'N8-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THR FRIDAY EXCLUDING HOLIDAYS. 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> I <br /> 3. A IIPU8LIC FtLES/RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FILESIRECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED 1MLL M <br /> COR4CTED BY THE EHO STAFF AT THE EXPENSE OF THE APPLICANT, THIS ADQITIQNAL <br /> SERVICE WILL OF BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 00 71 <br /> { <br /> 5. ORIGINAL PUBLIC FILFS/REC©RDS SHALL NOT BE REMOVED FROM THE EHO PREMISES. <br /> ....:............«,.... ... ............................... <br /> SIGN i TUR° OF APPLICANT yy�sc� DATE Yfza�Q> '-«•• <br /> I <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 4t] 14 IREV 9/96) <br />