Laserfiche WebLink
10-26-1994 08:12Ar4 FR0l1 L04RR /KR.AZAN TO 12094640138 P.01 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SMVICES 8 <br /> ENVURONmEr4TAL HEALTH DIMION �� I3sa <br /> mmuc REC.'DED5 RELEASE APPLICATION �� � � el <br /> APPUCANP 11� �eS PHONE NO <br /> ADDRP.SS -A 452r <br /> AGENCY NAME PHONE NO <br /> ADDRESS - - <br /> 'Zoo c <br /> PIIS ADDRESS :• :• � ? AGENCY DAM <br /> 4 S /fir. Broad a <br /> OL / p <br /> Q all �- Fr-c e•�s �f 51. <br /> — N' <br /> fl 244 pC, {0199 - <br /> p loa 4!. S�.,. �Z .35� TATH <br /> FIRM <br /> ri <br /> THIs N 13 suRmcr TD THB REQS WWnUMM IN TRE PUBLIc IwALTH <br /> SERYICIISIENVIRONMBN'I'AL HEALTH DLVISION(EHD)POLICY Vn-w.ORAINANcE CODE OF SAN <br /> JOAQUIN COUNTY, SW FRES AND SERVICE CHARGE RESOLUTIONS, STATE WATM CODE„ <br /> GOVMU M NT CODE AND THE EVIDENCE CODE. . <br /> I. A MAXIMUM OF TEN(10)PREMISE ADDRESSES PM REQUEST. <br /> 2. PUBLIC Fi1JEMCORDS RP3YIEW ARE BY' . AP'F'OINTMIINIS ARE <br /> ARRANGED BY CAL jNo (204)468-0340. OFFICE HOURS FOR AMWTMENTS ARE SCHEDULED <br /> MONDAYTHRV FRIDAY EXCLUDING HOLIDAYS. 8:0D A.M.TO 12:00 NOON AND 1:00 P.M. TO 4.30 <br /> P-M. <br /> 3. A PUBLIC RL?CORDS RELEASE APPLICATION AND A NON B—ERRTDM DBPOM OF$78-00 <br /> IS REQUIRED- DEPOSITS WILL, BE RvmqNED TO THE APPLICANT IF THE F9JWRHMRDS ARB <br /> NOT AVAIL.ABIE VAMUN THE CUSPODY OF THE EHD. <br /> i <br /> 4. THE ABOVE IDENT'IRED bEP05IT IS AP'PUED TOWARDS ME TOTAL FV.E REVMW FPB <br /> CHAROR THE BALANCE OF THE MARGES ARE DUH AND PAYABLE TO ASVISWING THE <br /> DOCUMENTKa'7. <br /> S. PUBLIC FILI MECORDS NOT RUMRNED IN THE SAME CONDITION AS RECEi1VBD WO.L llli <br /> CORRECI'F.iD BY THIS ERD STAFF AT THIF EXPENSE OP THE APPLICANT: THIS ADDITIONAL <br /> SERVICES*ILL BE BU TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC PH.ESIREL'IORDS SHALL NOT BE M MOVED FROM THE EHD FREMLSES. <br /> 3 <br /> SIGNATURE OP AFFLICANT �.Q `1 � _ DATE /V/2-5 Qy <br /> SIGNATURE OF RELEASING OM- CLAL DATE <br /> FH 00 14(REV 17,!97) <br /> - � ., TOTAL P.01 <br />