Laserfiche WebLink
PgBLIC RECORD RELEASE REDUESF <br /> 1 . REQUEST RELEASE DATE / PT J 192 7 <br /> 2 REQUESTING AGENCY PHONE NO. <br /> 3. AGENCY ADDRESS <br /> 4. INDIVIDUAL REQUESTINPHONE NO �11e- 0283740TJ <br /> 5. INDIVIDUAL ADDRESS C//.4 0 RCLC- <br /> GAFig Yrrre , CA <br /> FILE ADDRESS ITEM REQUESTED DATE PURPOSE OF REQUEST <br /> 061&11 CoL),uTRy aec/SioAU A40)e ,-CsT <br /> cl-o2, /3c u G(�o��JDwATeR �AT(� Q s/r-E 1.uuEsTi6a?�aN <br /> *ASTERI EMS U EPOR PHOTOCOPYING / /� <br /> SIGNATURE OF REQUESTING PARTY DATE_ <br /> LOCAL HEALTH DISTRICT USE ONLY <br /> PROJECTED RELEASE DATE <br /> SIGNATURE OF RELEASING OFFICIAL _DATE X23 9'2 <br /> NAMES OF STAFF MEMBERS INVOLVED IN THE RELEASE AND MONITORING OF THE RECORDS. <br /> EH 00 14 4/81 <br />