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ry F <br /> SAN JOAQUIN COUNTY <br /> `" ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E Main Street Stockton • CA 95202 <br /> (209)468-3420 •Fax:(209)464-0138 ■ Web:www.s' ov.or ehd <br /> racl o i <br /> t <br /> "PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD" COMPLETED? YES I NO <br /> E.R. BINDER COPIES: <br /> I SHORT-TERM NARRATNE ANALYTICAL PROP 65!UAR <br /> ON TOP DATA <br /> RECORDEXPOSUMANIFEST CLEAN UP REPORT OTHER AGENCY REPORTS f <br /> REFERRALS MAP FILE CREATED <br /> i <br /> f <br /> I <br /> F <br /> f <br /> I <br /> S <br /> 4 <br /> I <br /> k <br /> 4^ INCOAPORATED - <br /> Stacey <br /> r— P ant Snnitnrinn and Caiirpbnnce`Mnrlgger_ <br /> -c-elk <br /> - - Phone:.209/365=5701 <br /> 40 E.Neuharth Drive` w Fax:209/33_3=74.28 <br /> .�.r <br /> ! ma t M1ssilva9cottage 1 <br /> P.O:Box 1720 T We6sae:www.cotta ebaker}±.com 1 <br /> Lodi,CA 95241 = bakery.com <br /> ._ .i <br /> 'I <br /> i <br /> ER RECORD MODIFIED Page 2 of 4 05/01/2007 <br />