Laserfiche WebLink
Ell 00 14 (REV 5/94)0 SAN JOAQUIN COUNTY 4 <br /> lIU13LIC IIEALTII SERVICES <br /> ENVIRONMENTAL IIEALTII DMSION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT ,(� ✓1� tR PHONE NO g� 3, /� <br /> ADDRESSC+' u% (D <br /> AGENCY NAME ( Ll PHONE NO / <br /> ADDRESS Z,� 5(z { e G� GO ( (/r /ZO 3 <br /> FILE ADDRESS LEAD AGENCY DATE <br /> Ld f UOCE) <br /> Fty(c { <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) POLICY.994-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I, A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW Is BY APPOINTMENT ONLY. APPOINTMENTS ARE ARRANGED BY <br /> CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMFNTS ARE SCHEDULED MONDAY TIIRU FRIDAY <br /> EXCLUDING HOLIDAYS, 5:00 AM TO 12:00 NOON AND 1:00 PM To 4:30 PM. <br /> 3, A PUBLIC RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDrrION AS RECEIVED WILL Be CORRECTED <br /> BY THE EHD STAFF AT TIIE EXPENSE OF THE APPLICANT. T116 ADDMONAL SERVICE WILL BE BILLED TO TIIE <br /> APPLICANT FOR PAYMENT. (SEE EHD POLICY 94-007) <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM TIIE EHD PREMISES. <br /> SIGNATURE OF APPLICANTp DATE r <br /> SIGNATURE OF RELEASING OFFICIAL Q' J �" "y` DATE <br /> NO PHS/EHD RECORDS/FILES ARE IDENTIFIED: <br /> PHS/EHD RECORDS/FILES EXIST ON THE ADDRESS(ES) NOTED. YOU WILL BE NOTIFIED WHEN <br /> RECORDs/FILES ARE AVAILABLE FOR REVIEW: <br /> Ilm,...n..: Nmnw:wniw oat <br /> r <br /> ' 1� <br />