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I:-J h 1 5:l3 I Pt-1 r F+ Auc ivy ccs a rev c r i c,v <br /> 9�7 -/3 a, <br /> SAN JOAQUIN COUNTY <br /> PUBLIC IIEALlnl SERVICPM <br /> ENVIItONINIE.NTAL IMA.MIX DIVISION <br /> PUBL.EC RECORDS RELFASE APPLICATION �1 <br /> APPUCANTC fi, Ir. �a[1i�1�[Cfl p�PITONS NO <br /> ADDRESS ao <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> FILH APP-19 .SS Lgn AgIONcy DATF3 <br /> lwoo <br /> ��� i- .-_•t J��.,�.1���-�•+-- 1 I � .CJS•a..� M n� _�.r_ <br /> 371IS NonC13 IS SljajrCr TU 7130 I�EQUIRENII;N-IS 1DITI <br /> EPFIFD IN 111E PUBt.IC 11FALTH <br /> SRVIC2=SYFNviRt)NM NTAT,HFAI,Tl1 ()[VISION(11;110) P011CY r43()07,nRC1INANC£CQDE OF 3AN <br /> E <br /> JOAQUIN COUNTY, rIID FJBP-9. AND SERVICE CHARGE RESOLIJ1YONS, STATE WATER .:ODE, <br /> OOYERNl46NT CODII AND-nIlB 6VIDENCH CODE. <br /> 1. A MAXIMUM OP'i•z;11 (10)PREMISS ADDRESSES PER REQUFTr. <br /> 7. PSIRI.IC FII.rjsiR1rC012 5 RFV[I=W ARF. FlyC]!t1=NLS?�Ll� APPOINTMENTS ARE <br /> ARRANGED BY CAIA ANG (2-99)468-0340. OF(=ICE IIOURS FOR AppOINTMENTS AHI; selIC--DUL.ED <br /> MONDAY -nIRU PlilDAY EXCLUDINO 110LIDAYS, 8:00 A.M. TO 1200 N0014 AND L:OQ P.m. f0-4:3o <br /> P.M. <br /> 3. A PU[3Ll4C FILCORL)S RbLEASE A11PLICA110N AND A I-oN-FtEE'UrjP I D1 POSIT01"578.00 <br /> IS RLQUiRE?D. DE=POSITS W'((L [3E REl'URNED TO THE APPLICANT IF T14E I'll-l`SIREC(3RDS AILD <br /> NOT AVAILABLE WITHIN TH11 CU51'0DY OF T118 E113D. <br /> 4. -nIF ABOVE 11%NTIMED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE Rev7EW FEE <br /> CHARGE. '111E BALANCE OF'lil. CILARGF-S ARE DUE AND rAYA-BLE ZRI()R TO Rly'VI>:WENt3 771E <br /> DOCII&IFN'T(S). <br /> 5. PUBL3C FILESIRECORDSjgO`r REIJRNEII IN TUE SAhle CONDI'nON AS RECEIVED WILL BE <br /> CORRECTED BY THH END STAFF AT 7171E EXPENSE OF TIIS APPLICANT. THIS ADDITIONAL <br /> SERVIcu WILL BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FII.F.SIIIECORDS SHALL. NOT BE REMOVfil) FROM TETE EI-EU PRfi)'USES- <br /> SIGNATURE OF APPLICANT y�-_- DATE <br /> S10NATURE OF 11131tRAS[NG OPPICIAL DATE <br /> Flt 00 14 (REV 12192) <br />