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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT -71 NO S!-a d7 <br /> ADDRESS -3,s L4 n r)a Ic 6 t' IZ y' es' CA <br /> AGENCYPHIDNE NO <br /> ADDRESS <br /> .i <br /> 1� <br /> F11-B ADDIiBS� LEAD AGENCY PATH <br /> lrllf-XAA CQ <br /> _ A <br /> �f n F . Wt ATY1 n ia AA_4 Cn <br /> l <br /> I I, <br /> 1 <br /> if <br /> If <br /> TIUS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SFRVICBS/ENVIRONMENTALHEALTH DIVISION(WID)POLICY#'92-007.ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, MI) FEE9 AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10)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 POR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> it <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUN12ABIX DEPOSIT OF$78.00, <br /> IS REQUIRED, DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WIHIN THE CUSTODY OF THE BHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CH/;RGES ARE DUE AND PAYABLE L'$[Q)Z TO REVIEWING TELE <br /> DOCUMENT(S). <br /> S. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAPP AT IRE EXPENSE OF T11E APPLICANT. THIS AMMONAL <br /> SERVICE WILL BE BILLED TO THB APPLICANT FOR PAYMFNT. , <br /> 6. ORIGINAL PUBLIC PI12MCORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> 'i <br /> SIGNATURE OF APPLICANT DATE <br /> I <br /> MGNATURE.OF RELEASING OPFICIAL DATE <br /> EH 00 14 (REV 12192) z <br /> _n'd EGSETSS1 01 Ilndj L'"SF:ll E66T-9c-8n <br /> It <br />