Laserfiche WebLink
J UNY 101 '717 fol.18 H i b^' r HA =VC-M n i:t� G47 <br /> t PoM4r Fax 7671 ' (,( pyl► "`1 <br /> 05-01-19% 08:39PM F Tori <br /> i <br /> Co- <br /> FAx A C7�f t f-X11 Fac A c, <br /> j $AN JOAQUIN COUNTY <br /> I PtIgLIC HEALTH SERVICES <br /> ENVIRONMEN,rAL HEALT1i DIVISION �. <br /> 7 G"0 <br /> PUBLIC RECORDS RELEASE APPLICATION , <br /> AP1r'I.ICA1 r �Ynl �l7�ccn,I F-1rl ;'--A ^—A _PRONE NO r _. <br /> ADDRESS _ <br /> AGEIv Y NAMEPHONE NO � G? <br /> ADDR SS <br /> *. e.�kw*+r�:wx*�**x�*•rx*t�r�t�#r�far*,r,r*�ftrf�ttt*�*�*��c,r�r,r�*:xsr+rsx*** <br /> r _ U N -*-j;AmEL .QG a3 <br /> FACIU- <br /> PlTnseo ST- r = l s�s <br /> i <br /> f11 <br /> a VA't 'cI`I j1/T .2 <br /> / F0,5d <br /> 'THIS. TICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBUC HEALTH <br /> SERV( 1:S/EWVIRONMENTAL HEALT}I DIVISION 1EH01 POLICY #94-007, ORDINANCE CODE OF <br /> SAN JOAQUIN�COUJTY, EHO FETE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVEF NMENT-CODE AND THE EV115ENCE CODE. <br /> 1. A MAXIMUM OF TLN LM PREMISE ADDRESSES PER RIEGUEST <br /> ii <br /> 2. PUt3LIC FILESIRECORDS REVIEW IS B`f '' S1t� ,4N�lLY APPOINTMENTS ARE PROCESS- <br /> ED BY �AL LtNG (2091468-3420. or-Pico HOURS Foo APPOWTMENTS ARE SCHLUOULED MONDAY <br /> THRU OAmA y EXCLUDING HOUDAYS, 8:00 AM TO 12:00 NOON AND 1;00 TO 4:30 PM. <br /> 3• '4: BUIC FILES/RECORDS RELEASE APPLICATION (PPAA) IS REGOIRED. <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> C0AFtf#TEq BY THE EMD ST"fl AT THE EXPENSE OF.THE APPLICANT. THIS ADDITIONAL <br /> SERVICi WILL 8E BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 007) <br /> e <br /> S. ORIaIN4L PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> seese►®•40 .`atA®•++••♦♦ + 4+wf•fAareaf004+ffIBf.�Qi4A'i'ffliAad+•♦14i•ff•ff.►fa <br /> SIGNATURE;OP APPLICANT 'Y1N .� �I DATE <br /> tuJ DATE <br />. SlGN�1•TU�EIOr= REl.!`ASlNG OFFICIAL <br /> EH 00 14 (R�V 9/96) <br /> i ; 1 <br />