Laserfiche WebLink
JLA_-26-2006 02:49 FROM:L 818)224-4985 12094640138 0•% �? <br /> •�" aui4evkiti3 14:39 CAMV. EWIR 411EW41- WALm PAG, St <br /> t(iV''' V SAN doAQvzivCottN�rx <br /> Part MGNMVrrALHRALTIRDITARTriErfl, <br /> 304 E Weber Ave 3'4 Floor stoctrtoa,CA 95205 <br /> JUL 2 6 2006 (209)468-?420 Fix:(209)46-9-0138 Web:www.Mun.joaquia.CT-WA hd <br /> ENVIRONMENT HEALTH 1,Tj'B1J.0 RECORDS RELEASE APPLICATION <br /> PERMI7d&Eq�46£f�•��� .m— --�--�- --__ _ <br /> mnI-.I) 7 Slgia) _st7,a,ia�arAcsscrt ss�s fir( . --- �._ <br /> }f11�s,(,,A q 13W <br /> ►rloitE: `:JK `la mesmtn.e: 0.1$ <br /> TExrr/,rave^wnvatrn7anaATc —..—n�:._..�.e.»,-.. <br /> often wiawtoxllwsstiast"940e«syph a,10maj <br /> prcrcmsutomorromsm: IT o F1e �e en► ocase�+naeusemrsalrnr <br /> siGmATuAzoFAPPLJCAR . ..._... uA-� � 2' .94) <br /> aammma un.czar <br /> to idPi3r Jere a rrrintPcn,ems _ p unit, <br /> Unit (p <br /> �9��� <br /> >C Ilnit3 <br /> Cl Wt9 <br /> ..2Y:7....-..-..�...�-..- - `r. per..-..-.__ —..._�..•� I <br /> fJi%gRO"EIdPAL MfiALTM DEPARTMMff PLE$ <br /> m N0h3lC1111KRai TAta,wall gA1M W sang 9.er) "OUR a ADATIeItENT o aalt1 Wry M FAC1 A'4' <br /> 4' lit t7.l8idllF anti ltA014i.IfF1 t7 F000 FACNtY I7 aotardWAa9&V79LRLL, <br /> t76MKe7GiLt7m'TAMcp'OOMIItIIRIfvGJIl2MC/N.1 5] 006 RlMMl;1. 1] DMIIt' <br /> �.Iriaf:LNa whale nEmlRrnYM a CNICKEMi4WSN 1.9 hltti lliWT4tiNr V:,.11'NT <br /> Cal17 PUtaaErt SRiSCiS7aRLN4r'1N TC71sl`J <br /> C 77Finmo?11t19fCYEa FACkTTY 13 LAAD fAM411TNbicIM: <br /> C ThTlRCNRiRM P@RCIb <br /> 1. Late u)I to tem miklmtlml In an spaom aboye, Select the typa(a)of MIS fitnn Cm NSI.stw)ra lay"A dnli <br /> ehm e�?propAana bux(arJ. AL Iaast onn Nh type MUST he eslactad. F57irt.�lds!!'a'i� �.fi"®��.ldG <br /> O <br /> 2. 1PII.I�t E1Jt�1Yi. <br /> P1Ll will wtN7fy+n m nppikmrd irony E:ItD rilu exW n <br /> An appointment Wr tlow willIm ccq immrd <br /> approulmaw tN0 tlustneu days tha no tater oew tan 11u0 days stmtrn"PlI t of Wllrstamm The hii4nt <br /> Vr¢h bn h fora in;Odimm 0 Nva buttiness days tar rsvtaw," Appotntmonla shouldb4 schodutnd <br /> 3. ill lttm that tt arXNrtfm bdM:Q wc,ked as b1'EMD ascot may not bs tmrr".adiaut.F rnitabty sa'r%T1w'. A rMw <br /> s:apWaatton moa'he adbmiitted whorl Rw NN is ov.011f . <br /> 4. Itmy Nta MW.tnttm7aaf @n tie sine Con~as r resod wFit be reegtrtnbFrAi 11Y FIND W4 4100 aotpstur0 <br /> cit the appr,%agM. 4'eksv7 Site rWk we tty the Sects app kant may raglutra n 13"t dsPa Ill.prior W tar'aw. <br /> 5. -1EtdTAr1YEE opp:Nr'tlecre dates Mull be ComNnmil with EMD sitaff. <br /> iaW tt <br /> B. /Ig ptit atidm:rsrohntd lifer 3^00 Pm lalll l�pocas:tad p• <br /> CONPIFTWOIL'PPCItNIM111117 DATE TME �.-�--- <br /> DATECa111-VIidED FHOXil PAif ttlfP4nlll <br /> f6'CVt:YM19:a - Tl:lh 140 DATE <br /> �.-a�-o� iaced,�l Pcaa#^iirxNmaa _n+n, � •_ ��.n <br /> td/1t�XE5- I'.55pT,Y/� iiRq�, a: �. <br /> IIPriY <br /> mar' I V r'7 / <br /> q_e-� cAlerii � ih��'n� fi��s`olcHOO ri/l f/»39✓ '�g2 I'P 'ev. w'q zssn <br />