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SAzv OAQUIN COUNTY' <br /> + '�P'UB.LIC HEALTH SERVICES .. .: <br /> ENVIRONMENTAL HEALTH DIVLSION <br /> PUBLIC RECORDS RELEASE'APPLICATION x <br /> APFUCANT PHONE <br /> ADDRESS //fit Q",zzu4 ecC 3oG scrK r C '9Srs�6 <br /> AC'fiNCY' NAME 2?Sk-_ a W Ssc I-a f es _ PHONE NO <br /> ADDRESS <br /> Ftr_n snnAps L-E-LAD AGAN= ". ' -=pg' ' <br /> ;?37'5'=%rac y T�oulL'fKtra!'�ltrci UST Ccttr�srdxlficrr L(�/l4 0r 07 gY <br /> SyscU.Gnxaf G�.r.� �'d- Tarc //a c ecaa l <br /> 243'-LU, GrrrArt Cine /Za✓. Tizxc z' <br /> Zszq. 77zzcy� T3/vaf., Lr_nc IV <br /> 1:1f'9 W,G;re t yf Li ci Ae!oP 77ne-r N J UiN C <br /> Z,/?oracy add_, %j cY HFµA ION I <br /> 7//+ jtt'ir�f (�;r.¢,G�ol, jzrcr ,s _• u::: ..{ <br /> THIS.NOTICE IS SUBJECT TO THE REQUIREMENTS IDENMTMD IN :'THE:'PUBLIC HEALTH <br /> SERVICESAW FRONMENTAL HEALTH DIVISION(EHD)POLICY,#'9'2.007,OItDINANCB CODS OF SAN <br /> JOAQUIN, COUNTY, &HD FEES AND SERVICE CHARGE RESOLXMONS,.,STATE,'-. <br /> CODS,. <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MANMAUM OF TEN (10) PREMISE ADDRESSES PERREQUEST.. <br /> 2. ptmuc FIIEmwcORDS REVTEW ARE BY <br /> ARE ' <br /> ARRANUND BY CALIING (209)468-0340. OFIWE HOURS FOR APP MTrMAN"I'S'ARU'.S`C'IIFDVLED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON.-ko 1. PQM:'Ib 4o0 <br /> P.M. <br /> 3. _'�'A PUBLIC RECO=RMAASE APPHCATION AND A DEt�OffiT''OF�?S.OW <br /> IS RBQtM=. DEPOSITS"WILL BE RETURNED TO nM'APPLICANT T.�IF'I�3R1}.B `' k <br /> NOT AVAn 4B E wrrW t.THB CUSTODY OF THE EIID. } r V C f y�h47�' <br /> f � _�.� i;.a i' .. - �,Y -.::°S{5 -+Ss��. 3+,-fit i• �• ' ;-Y ,.,+.4. <br /> i <br /> . 4. 'THS ABOVEEDEN71FIED DEPOSIT 13 APPLIED TOWARD$'' 1S'1'�I`A�►PTL�B RSV E r-,•,: <br /> CHARGM THE BALANCE OP THS CRARGES ARE DUE AND PAYABLE IMM-"TO REVIEWING 7=11­11'.Zr`,^,;... <br /> ' DOCUMENT(S)./S}. s -, . 4 $ { ..r !�` u� i •• �„ r,s Zrs A R <br /> F; $ •.• .`�'"' +-•t.F "S r tel. <br /> 3. ' . IPtJBLiC FELlWl=RDS NOT RETURNED IN THE SAME Ci�tDi'T�{7fit l� <br /> w� `S`' ~ w <br /> CORRECTED BY'T0�'9= STAFF AT THE WENSS OF'THS A iICANT� THI9 AD ONAL._ <br /> SERVICE"WILL.SE IW IlQ TO THfi APPLICANT FOR PAYMENT.A,k j <br /> 6 { oRlcn�Al~PUWC FILES; CORDS SI-Lik NOT BE REMOVED MCM TIM EHU MUMOSES. <br /> +,:, 1 .--'.1� J{ .. .. .: ga'as-- yl. a.: - . t +;r,n :y�±�.� hA -4r 3F'. its ,i�. - , _�_ '•t s t LES ;' <br /> SIGNATORE OF AP!'IICANT DATE' <br /> SIGNAWRE OF RELEAANG OFFICIAL DATE <br /> EH 00 14 (REV 12192) r r <br />