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1 yh/ O=ICJVHI`1 1 I\V••' `+V l.. ..- --- ...-- -- <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEA.LTII SERVICES <br /> ENVIRONMENTAL TIEAI:Ifi DIVISION <br /> /YUBLIC RECORDS RELEASE APPLICA'T'ION <br /> APPLICANT i I� .�J p PHONE NO <br /> ADDRESS /ffo r. AA <br /> AGENCY NA vffl PHONE NO <br /> ADDRESS <br /> jjLI3 ADf)RFSS LEAD AO;ENCY DA <br /> S Te1�i�� _ <br /> `1733 <br /> 40P ,t n ti H j Z-T <br /> P I P 4 --nom n ✓ _ _ _ <br /> of J` J b <br /> -35--2--7 rn� <br /> S �ac�a—Sf- --- <br /> 1'IjIS NOTICE'- IS SU131t:CT TO 111E REQUIRE mENTS IPENTIF1ED IN THE PUHIdC IIEAi.:I'I4 <br /> S�RVIC�'SlE NVIf20lJh4IiN'i'AL1{EAI_ -11 DIVISION (FIII)) i'OI-IC'Y X6'92-qp7,ORDINANCE CODE OF SAN <br /> IOAQU1N COUNTY, E.HD FEES AND SERVICE CHARGE RF-SOLUI-IONS, STATE .WATER COD1r, <br /> GOVERNb1ENE'CODE AND T1-IS EVIDENCB CODE. <br /> 1. A MAX161UIy1 OP TE14 (10) PREM.ISB ADDRESSES PER REQUEST. <br /> 1. ('f IE31I(' Fl REVIEW ARIL IIP A1 PO[fJThLrr4T 0_1`71.1'. APPOINTMENTS ARE <br /> ARRANGED BY CALIING (209)468-0340. OFFICE HOURS FOR APPUIN'I'htFNTS ARE SCHEDULED <br /> NIONDAY"11iRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 3. A Pll13I_IC RECORDS RELEASE APPLICA11ON AND A NON-REI'LINI^Q7 I jis DLE'(7SIT OI--$78.00 <br /> IS REQUIRED. llFYOSFfS WILL HP RE_FURNED 1'0 THE APPLICANT IF Iul-: FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN TIIB CUSI'ODY OF THE HHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT 1S APPLIED TOWARDS THE TOTAL FILE REVIFIV FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUI? AND PAYABLE 'I2F 1OR TO REVIEWING THE <br /> DOCUMENT(S). <br /> S. PUBLIC FILESIRE:CORDS NOT RETURNED IN TILE SAME CONDITION AS RECEIVED WILL BE <br /> CORREC PD BY TIIE LHD STAFF AT T1IE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILI-ED TO THE APPLICANT FOR PAYMENT. <br /> b. ORIGINAL PUBIIC PILES/RECORDS SHALL NOT BE REMOVED FROM THE G1iD PIt1;M1S7LS. <br /> SIGNATURE OF APPLICANT DATE . <br /> SIC3NA"RJRE OF RELEASING OFFICIAL DATE <br /> Fil OO 14 (REV 12/92) <br /> c� <br />