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09'25/200a 11:53 2094b8Nl� FIFTH FI-DOR PAGE 02 <br /> SAN io-kQUIN COUNTY <br /> PUSL;C HS.A SERVICES <br /> F.NVIRONIvIENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> AP P L ICAU1'F U f i Ho�•>E rro 7/6 32--els a- <br /> D,.1.0RESS 1000 or-i-e�c� Wa—� Y1 et C�-�'iC,. Li 'S?a --1 1 l8 y <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> **���*��#z�*t*�•-r•t*�cx�e�c�r�,r,r*�r�:;et*t**t***w;r*re*'k�rkirt�c*t,tt**-ar**�rrw+��r* <br /> FULL IiDDRESS SUSINgSS NAME/ PROGRP-M OR <br /> 'R�SL.C'PY TYPE OP FTt,R <br /> _4w,;.Fp' 3 o 5,02 <br /> S'a :1 opt <br /> * k''k� tY***•*-k##* Ir•k it t it�r Je'kw•�'*wt4*'�+k*:F•k•* le ye k'*#'*i****•ir ai'*�llr*'kfi-t**i****** <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PL LIC HEALT'ri <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHOI POLICY #94-007, ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE Acus THE EVIDENCE CODE. <br /> 1 . A MAXIMUM OF TEN LLOJ PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILESIRECOROS REVIEW 1S BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING 12091468-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FSIDAY EXCLUDING HOLIDAYS, 8:00 Aldi TO 12:00 NOON AND 1:00 TO 4:30 PM_ <br /> 3. A PUBLIC FILES/RECORDS RELEASE APPLICATION (PRRA) 1S REQUIRED. <br /> 4. PUBLIC FRESIRECOR05 NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE. <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL. <br /> SERVICE 'WILL BE BILLED TO THE APPLICAN'P FOR PAYMENT_ (SEE EHD POLICY 94-0071 <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL.NOT BE REMOVED FROM THE EHD PREMISES. <br /> •..•..�•. •+.r.ra•.e��.►•••••••�••a •a 7'•T ♦Yay•�.a.aa•a.a.•�+ •�♦.a J��a�t•T <br /> SIGNATURE Ot< APPLICAIUT ti �DATEor � <br /> SIGNATURE OF RELEASING OFFICIAL \.G[f DATE �g C)D <br /> EH 00 14 (REV 9196) <br /> Z0 39va IlV3 V5L9ZE9VTL TT:ZT 000Z/SZ/60 <br />