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U - P J316C HEALTH <br />SAN JOAQUIN COUNTY <br />_fes• ��,, <br />JOGI MANNA M.D., M1Y, <br />w G <br />.P.H. N t� <br />a <br />llelllh A Officer <br />P, o. Flax 2009 <br />( . <br />• If,01 Chat I-Inaelum Avcntte) . S�nckinn Cn' <br />litrtmin 951(11 <br />r: <br />(209) 4CR-34181 'L!�,;,��. <br />r-rrn. <br />n.Mn.RCIUN Y RlrsrUNS1? RI?CURD <br />DISITttcr *�3a s - <br />IMTF:� <br />PRUMISP AUDRRSS <br />DILA <br />PRRMISPOWNER <br />/ <br />AODRESS ��� c� -� /J c•:• <br />FACILITY CONTACT S <br />700 <br />NATURL� UT COMPLAINT (Anal° <br />1 s / 7/ enlS fi►r, or nhnndon/dungrn <br />rl 111rerinlJ: <br />1'I41! RP.CEIVEI)Vii» <br />TIME Or ARRIVAL,-j� 7-IMr: or urrnit*rt11t1? ��, 3D/�� <br />PERSONS AT SCENE? (Jr) 3 <br />NAM—p- <br />�1UENCY _ PIIUNI? No. <br />%O <br />Gve-(mzt,, .4e -w <br />1OFMIr•ICATION Or MATERIAL (altmIcA rawnvre� ��' 3v�•n <br />SU1)S'1%1NCE VORM: [) SOLED `� <br />I 1 rUwul7lt Ir, � 111.Iuu1u <br />Rr_r•ERItALS'rO: �s t� 3e4f.,tQ I I cntAN1)1.r <br />VATLr COMPLI? TgU: PROP 65 MA11.1?1): <br />UAR - <br />PIrRSONS PXPOSEU nnd/or INJURED <br />AM r_ <br />)DRESS <br />,.'I TY NU. <br />INVMIIOATION REPORT (INCI.UM MbINCS, C(swN Ur, "MA4MEN"TIMq <br />and MAr) <br />Ct ccc, c 8 <br />1711-P CRnATI?U <br />I MAP 1NCl,UI)I?U ( SIIURT'17?RM A'17ACI11?I) lut <br />A l)iviiinn n/ San Jr►aquln (:minty I lealth ('.Pre Service 0 <br />