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_ R A. Box 1!X)5 <br /> + <br /> Stockton, l+t 9b101 <br /> • (105) 4;.-54'.:,l <br /> y <br /> jog AtPotfRa, M.U.; Healt.h if i item <br /> SREWO <br /> S & R E66 RANCH S & R EGG kANCH. <br /> <br /> <br /> <br /> .'-. AC4MF.3, GA 55ii'.22-v <br /> sill ing Statement. rr;^ :crib]t; !1nderyrC�uih7 ian}: Fan ilt�w. <br /> ^t .teAlent Date - <br /> Payment Ike• Date, Abyss t M."! <br /> Fawlity Fm By III <br /> Container k!mOrs u0b 15.00 <br /> TUTA FEE; IWE 37S.Gu <br /> MES. <br /> 7.ijtlfy Public Heal Ut Sevvite5, <br /> ',ave arjaquin l,vUnty of any <br /> corrections or changes <br /> necessary. Your o:mmit will <br /> ue mai led '•,POT, receipt. of <br /> payment arni approval of <br /> facility. <br /> Fehr:{ paykent along with one <br /> o y of tris. Et8temm to: <br /> PULIC HEAUNI cavi' E3 <br /> CAN JiINUII (W4Tr <br /> ?t•; RU?•M)ftTAL KEAL?H PERM!TlSERVICEG <br /> STOCKTA CA 5510 <br /> Penalties will be aojed atter <br /> duc da Lt' as show�1: <br /> V <br />