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SAN ,)OAQUIN COUNTY <br /> %. p.KMLIC 1IEALT11 SERVICES ✓ <br /> ENVIRONMENTAL ARALTII DIVISION <br /> MMLIC RECORDS RELEASE APPLICATION <br /> APPLICANT <br /> 1 � IN t.ovS� FIiUNB NO S/P/ 602 - 6 /00 <br /> ADbR,ESS_Z4o1 G_-{a^w .g, � <br /> SILT-((gyp on ucd CJ4 q <br /> AGENCY NAME <br /> —1CAPR�-Ru -nt �NC��uff��r!': 'S••i�F'H(7NE NO <br /> ADDRPSS <br /> FILH ADDRoS LE�b AG131Y�( DATE <br /> 3oIq NAS , TtM ,mt <br /> SOI S N�Jv D fL T,M`— 0,L. Cot-+po -�i <br /> W e u.ic/<13 � Sin. � GA.�S�/ •. �S C���ef+ arr- 1t•�r.�y},�ylr/ <br /> ✓�s/4 ' 4I ae.' r- N Tce.,"ic y/ .�s;✓iu ✓ e.,+.h4s k� At nc/•,c/�e�is f� <br /> oL irc s . AE s. u/c <br /> TIIIS NOTICE IS SUBJECT TO T11E RF_QUIREMENT:S IDF,NTIFIED IN TI18 PUPUC HEALTH <br /> SERVICES/ENVIRONMENTAI.HEALTI4 DIVISION (EMO) POLICY//o2-007, ORDINANCF CODE OF SAN <br /> JOAQUIN COUNTY, EIID FEES AND SERVICE CHARGE RESOLU11ONS, STATE WATER CODE. <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I. A MAXIMUM or. TEN (10) PREMISE ADDRESSES PER RE(1UP-w. <br /> 2. PUBLIC FILF-S/RECURDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR 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 /> 3• A PUBLIC RECORDS RELEASE APPUCA11ON AND A NON-REFUNDABLE DEPOSIT OF 578.00 <br /> IS REQUIRED. DEPOSITS WILL Be RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABI.E WITHIN THE CUSTODY OF'THE EHD. <br /> 4• THE AROVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS ITER TOTAL FILE REVIEW FEE <br /> CIIARGB. 714E BALANCE OF THE CHAROES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> OOCUMENT(S). <br /> 5. PUBLIC FILES/RECORDS NOTRETURNED IN THE SAME CONDITION AS RECEIVED WILLBE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. , <br /> 6. ORIGINAL PUBLIC FILES/RSCORLIS SHALL NOT 9E REMOVED FROM THE EHL) PREMISES. <br /> SIGNATURE OP APPLICANT <br /> SIGNATURE OF RMEASING OFFICIAL DATE <br /> EH pO 14 (REV 12/92) — -- <br /> TO*d =090 S40TST 01 fL�j IJHSc:TT '�55i-5GJ- k7 <br />