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77-08-1993 01:38PM FRO* Y v TO 19163641966 P.02 <br /> PUBLIC IIEALTN SERVICES <br /> FNVIRONAWNTAL H ALTII bIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION, <br /> APPLICANTAT%C k/VV110) 160t TIL LUL SIVI&A�MONE NO <br /> ADDRESS1 jk Kbv L 0 Sa 1Tk w C Ad1l�fi. rl �� y, y1 7 <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> BLE ADDRESS LEAD AG$NCY DATE <br /> E CAIC(oa fps <br /> THIS NOTICE 1S SUBIHCT TO THS, REQUIREMENTS IDENTIFIED IN TIIH PUBLIC HEALTH <br /> SERVICHS/ENVIRONMENTAL IIHALTH DIVISION(FI-11)) POLICY #924007, ORDtNANcv CODE OF SAN <br /> JOAQUIN COUNTY, END FEES AND SERVICE CHARGE RESOLUTIONS, STATE. WATER CODE, <br /> GOVERNMENT COUH AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OP TEN (l0) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY AUUINTMENT ON APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)469-0340. OPPICH HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 9:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUNDABLE DEPOSIT OF$79.00 <br /> IS RBOUIPRD. DEPOSITS WILL BH RETURNED TOT1113 APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSToDY OP'IHH EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT 1S APPLIED TOWARDS THE TOTAL FILE RPVtHW FEE <br /> U11ARGE. TIIH BALANCE OF THE CHARGES ARE DUE AND PAYABLE Mpg TO REVIEWINO T'FIE <br /> DOCUMHNT(S). <br /> 5. PUBLIC FILES/RECORDS NOT RETURNK.)IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OP THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT POR PAYMENT. <br /> 6. ORIGINAL PUBLIC FILES/RPCORDS SHALL NOT EH REMOVED FROM THE HHD PREMISES. <br /> SIGNATURE OF APPLICANT DATE <br /> SIGNATURE OF RE_LEASINO OFFICIAL UATF <br /> 1311 00 14 (REV 12/92) —' — <br /> \X <br />