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SMOAQUIN LOCAL HEALTH DISTRICT <br /> MASTER FILE RECORD <br /> DATE 2 2 - 3 - <br /> NEW <br /> CHANGE <br /> DELETE <br /> DISTRICT —�� COMPUTER NO. N c5e IHC. CITY <br /> DBA c� <br /> - � �CP°Z <br /> PREMISE <br /> ADDRESS �/ �CyL h PHONEESS <br /> BILLING NAME ��Lh�c.p <br /> & ADDRESS 36 71�S�os- <br /> OWNER NAME <br /> & ADDRESS 3(� 7 S Q ac �E G° 2 SfIT.0 7 o5 <br /> FEE INFORMATION FEE BASE FEE EXEMPT <br /> OTHER PROGRAM <br /> ACTIVITIES <br /> PREVIOUS COMPUTER NO. <br /> PREVIOUS DBA <br /> EFFECTIVE DATE (If different): SANITARIAN <br /> COMfIENT�S;-� <br /> CHECKED BY <br /> ACCOUNT CLERK <br /> FILE CLERK <br /> EH 00 15 REV11/83 11184 500 <br />