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10/06 98 TLiE- 16:07 ['_lX 2094671118 1G 5T0CK7'0\ r`ln 02 <br /> of 1�V L__ JQ <br /> t-f t SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES y� <br /> &N-,/)RON?1'FFN'TAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT dl vl PHQNE NO <br /> ADDRESS0 J 1 SO�? <br /> AGENCY ?MARE PHONE NO <br /> ADDRESS <br /> FrIL13 t=RESS J—FAD AGENCY UA: a r <br /> 500 A) U n <br /> 3D5 f) <br /> Iola Lo y os-e=m n QLn <br /> 1poo W. nj ton kA, n6asiN:2CCL .— <br /> TRIS NOTICE IS SUBJECT TO THE REQUIREMENTS 1DEN7FIED 3'I 71HE rUPLIC REAL:LH <br /> SERVICFSII:NVIRO,NMEVTALiiEALT14 DIVISION(EHD)POL:CY#92-007,CRDINA-NCE CODE OF SAN <br /> JOAQUIN COUNTY, FJID FEFS AND SERVICE CHARGE P'SOLUi10NS, STATE WATER CODE, <br /> GOVER" MENT CODE AND TP-E: EVIDENCE CODE. <br /> 1. A ll-WO IUM OF-1-::N (10) PRE? ISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILESIRECCR.DS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARR.AINGED BY CALLING (49)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SC:-IEDULED <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 P.ELEASE APPLICATION ANN A \'ON-REFUNDABLE DEPOSIT OF S78.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILE-SIRECORDS ARE <br /> NOT AVAILABLE 'A'ITHIN 71HE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDF-N-nFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BA -MNCE CF THE CHARGES ARE DUE AND PAYABLE PRJOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> S. PUBLIC FILES/RECORDS NOT REMUNED IN THE SAIME CONDITION AS RECEIVED WILL BE <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 FILESIRECORDS SHALL NOT BE REMOVED FROM THE EHD P-OLF- ISES. <br /> 1 <br /> SIGNATURE OF APPLICANT, _ DATE <br /> SIGNATURE OF RELEASING Cr-FICIAL DATE <br /> EH 00 14 (REV 12192) <br />