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PHONE NO. : 209 369 4228 Aug. 01 2002 03:47PM P2 <br /> FROM NOR Erni i ronmen to l .«.,«mMy IAL HEALTH 13Tiff <br /> N �+' �EC O V ED <br /> :30 .ASrwl�AyMtts>:,-rMM �J <br /> TMC$CTM CA us= <br /> (om)40-UU AUG 0 1 2002 <br /> PU$iSC RECORDS R£ SE Ap>PLIa Fat LTH <br /> cRyInUP <br /> i►vpz, r .c '�2 euatK = W Cl tr o• lk•4n Irk N ESB iuICES <br /> MMS 2-1-.) r d- k�O U� F.l l.A-ty� (_O h>-i CA C462-4-0 <br /> vmowr. - <br /> TEWA'nV0 AvPotNrMW MATE 1510 Z. <br /> an""an.r to 7 o eu ttaas ; © �i?2 <br /> Q MCX Box To Ewrnttz PMUZST• t_ <br /> SIGNATURE QF APPLJ=NT DATE 2- <br /> CL Qu- <br /> 4 0 � <br /> .4r% a GG <br /> �^Ni a�V C��/rin �„�-r•`t'�.� IQZS �. �1 r' Jr7�Ac� <br /> RQIiNII 'ALHIE:AL'�{QIViS WI F LF.S <br /> It WOMUMM TAMC MM CSS"P CM(Wn p4=W AMC =W V9ASM FACT M <br /> OTMCi AW, UMpidZAAM a V=FW Q StxsawASTAVF3ttc <br /> UNosx�cuNC TAatc(NtoNTrozs OnUM avAL) a aoG . <br /> tu►zat,00usvrAt� �e CIAM <br /> C RANCH dQPtt MWAIWWPLANT <br /> C MOM RVMMMMM TACiLCT b W nmiHo ElQ Plt�eASRLttStKARNQioit4A�n <br /> G TAT pip is Q tAttott3t;1►oPL1CA�lCNStTt'S <br /> R �iCALYYAa'C>:FACtt.tZlf G �mtawAMM w=T= Zr0nMXMXMCMWVAZMq <br /> 1. LIM Up to ton nddrsssoa in the apaoa sbaVa. goso the types)of c=from tris an above by dmo ttq <br /> the zappsopg4ift bcAss� At toast one filo tips muss be swse:ed "'14.�.�g?EZ&zn or MEH to thr <br /> PAO SO IndlCatod above_ <br /> z. MW wul notlty tW aWi=Wt l:"EH.O ftes eXlt AnappcWw@ntfcrnw1avwWbAcQ0ftwW <br /> FPO 94 flue bu:inoss days but no lateram ton(10)days aftw rueipta appg=tlott_ MA flt.s <br /> WM be tMM for*rMudovot of lira bt XUWM dXPfor ravtaw. AW1Wn8nts should 1M scttt�ied <br /> 3- Aft am�t�sacttvaty tyoing wctkad ctt by EHO tuff <br /> the <br /> appllcathm be subMIUOd w y not baiQnrttodiataiy available for rovuw. A now <br /> of <br /> . iiia not rautraed to viai• hen the tits to avattabla. <br /> 4 . <br /> �°�+Cition ss reicasret wits ha rac Mantzsd ny EtiO xMf!at tha expense <br /> S. <br /> applicant. Future mo MVieWr'tly the ado=ppticattt tray Tgquitt!s S=Q d�Cpo3k pnorto caview. <br /> 'TEWA'#WE appointment"ton tnU&t tzs carsttmted with MW ttatt. <br /> L Applications rec sivad aftar 1:00 pm wilt be <br /> Qrocassud ttie nsYx buslttsas daY. <br /> i <br /> 1 CONFIRMED APPOINTMEN-t DATE 't11dE ` <br /> IDAZE CONFIRM 1 <br /> PHONE FAX INMALS <br /> REVIEWEn YES No R1=V►Ew oAT� <br /> W Q 1. pgwM <br /> n <br />