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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES• <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT I� vl Z7 { e V'3:c.++vi s PHONE NO <br /> ADDRESS t:5 3 ,3 i S" I l <br /> AGENCY NAME PHONE N <br /> ADDRESS <br /> FILE ADDRF-S-S LEAD AGENCY DATE <br /> �n►r,�lc� �cJi ( 6 vi lo��. s <br /> L )cb , �t PAYMENT <br /> 1 RECEIV D <br /> °�aT S��i I IS �t�ll>°vi I✓i MAR 17 +e94 <br /> S �rc k•keA C,✓ /i-L,i le<<. UNTY-- <br /> PLI IB Ir HEALTH SERVICES <br /> LENVIRONMENTAL HEALTH DIVISION <br /> l /\AYwl\Y',t' i✓ S. vi —)c1\RL v1 Lr�•� (, <br /> C+� F w41+✓�+ \ <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICESIENVIRONMENTAL HEALTH DIVISION (EHD) POLICY#92-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD PEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> i. A MAXIMUM OF TEN (I0) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY T14RU 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 PUBLIC RECOP.DS RELEASE APPLICATION AND A NON-REFUNDABLE DEPOSIT OF $78.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/FX-CORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> 5, PUBLIC. FILES/RECURDS NUI KLI UKNhD IN 'l HE 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 APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT DATE 3//6�i'`/ <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 12/92) <br /> TOTPL P.02 <br />