Laserfiche WebLink
IT CORPORRTI0I1 / SRC Fax:916-361-3047 Jun 2 '95 1.0:23 P.02 <br />Eli UO 14 (1tZA94) BAN JOAQUIN COUNI0 Ag(�� i�q. -((l( <br />ENMONMOffAL EtEAL'TH UpvWION <br />PMLdC RECORDS RFIX%ASB APPUMION <br />APPLICANT J c + �+ a PHONE NO (9 I b- 3 61- 6 73 <br />ADDRESSWYa(' Old 191+ctryOlt A4 SA.t'tt tic, Sw-omenly, GR 95B'LT <br />AGtltdCY EQiAlV1II ; 17- co" t o. a fi .+. PIHQNE NO s + h e- <br />ADDRESS ! S. N1 i i — <br />i <br />lw�An er�� iZt1'.i:F�' <br />PHS- b ND; Ali <br />THIS IgUn i is stiMSUV 'lv IAB n6f4UIk8M6NTA IDER"PIP-15 IN THE PUBLIC HGAVI'll <br />smvImwErvjRulMnNrALHEALTH DAVISION (EHD) POUCY. #94.007, ORDINANCE CODE OF SAN <br />JOAQVIN COUN'T'Y. AHD PBES AND SERVICA CHARGE Rl3$0LUTI089, STATS WATER CODE. <br />GOVHRNMAINT C 09 AND THP Ill 1lDENCH COLW, <br />L. A MAIUNUNI NP TUN (10) Pk6M136 ADDRESSES m R6QURlt- <br />I .r <br />2. PUB�w F1LE$1RECORDS REVIBW 8 sY APrOINTTICNT ONLY. ArPolNrmcws ARs ARxANO&D bT <br />204 <br />CALLING ()468-0]40. OFMCti HOURS FOR APPOINIMxNTS AkB SCIODULCD MONDAY TIIRU PhIDAY <br />+j,J, (CLUUINa.HOLS6XY51 8:00 AM to 12_00 NOON AND 1.00 PM TOI4:3U MI. <br />I <br />3. A V69LIC RSic Rne ReLRAsa AmICATION (PA" N RDQUIR6D. <br />A. rut,c L.wrItLCi7 m Nov R6YUR14e0 IN T116 IAMB IM49!l1Oil AS'RCCIWBb WILL De COP-RCCgtD <br />11Y INR FJill STAFF AT TNP MOCHS! (W TTIIJ APPLtEANT. TUa Ato"NAL UAVICU WILL = BRA" TO Trill <br />ArPLICNM FOR PAYMENT. (Stilt EHD POLICY 944W) ' <br />I. <br />S. 0*01NAL PtiU.xW PILWimcmus SIIALL NUT Be R6MCYRDIPttON Tim EHD rRQ i3sx; <br />RIONATIIRpi DP APPIXAHT DATE b..Z 9 s <br />I _ <br />SIRNATURb OF ItfiLEASINO OFFICIAL ! DATE <br />No PIISldio !(JlvsiVWFILUI ARU 001trIM, <br />LIAR ' . Pmww so VAM <br />PHSIEHO RSCDRIWFILA7 EXIST ON TNe ADDRE38(8l) NO=. YOb1 WILL. ki NOTMED WGZN <br />RECO"SiFlUd Aitk APAILAOtt MR PETIM: <br />TOTAL P.B2 <br />7Q i <br />THIS IgUn i is stiMSUV 'lv IAB n6f4UIk8M6NTA IDER"PIP-15 IN THE PUBLIC HGAVI'll <br />smvImwErvjRulMnNrALHEALTH DAVISION (EHD) POUCY. #94.007, ORDINANCE CODE OF SAN <br />JOAQVIN COUN'T'Y. AHD PBES AND SERVICA CHARGE Rl3$0LUTI089, STATS WATER CODE. <br />GOVHRNMAINT C 09 AND THP Ill 1lDENCH COLW, <br />L. A MAIUNUNI NP TUN (10) Pk6M136 ADDRESSES m R6QURlt- <br />I .r <br />2. PUB�w F1LE$1RECORDS REVIBW 8 sY APrOINTTICNT ONLY. ArPolNrmcws ARs ARxANO&D bT <br />204 <br />CALLING ()468-0]40. OFMCti HOURS FOR APPOINIMxNTS AkB SCIODULCD MONDAY TIIRU PhIDAY <br />+j,J, (CLUUINa.HOLS6XY51 8:00 AM to 12_00 NOON AND 1.00 PM TOI4:3U MI. <br />I <br />3. A V69LIC RSic Rne ReLRAsa AmICATION (PA" N RDQUIR6D. <br />A. rut,c L.wrItLCi7 m Nov R6YUR14e0 IN T116 IAMB IM49!l1Oil AS'RCCIWBb WILL De COP-RCCgtD <br />11Y INR FJill STAFF AT TNP MOCHS! (W TTIIJ APPLtEANT. TUa Ato"NAL UAVICU WILL = BRA" TO Trill <br />ArPLICNM FOR PAYMENT. (Stilt EHD POLICY 944W) ' <br />I. <br />S. 0*01NAL PtiU.xW PILWimcmus SIIALL NUT Be R6MCYRDIPttON Tim EHD rRQ i3sx; <br />RIONATIIRpi DP APPIXAHT DATE b..Z 9 s <br />I _ <br />SIRNATURb OF ItfiLEASINO OFFICIAL ! DATE <br />No PIISldio !(JlvsiVWFILUI ARU 001trIM, <br />LIAR ' . Pmww so VAM <br />PHSIEHO RSCDRIWFILA7 EXIST ON TNe ADDRE38(8l) NO=. YOb1 WILL. ki NOTMED WGZN <br />RECO"SiFlUd Aitk APAILAOtt MR PETIM: <br />TOTAL P.B2 <br />