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SANJOAQUIN COUNTY <br />04WRON MENTAL HEALTH DEPARTMENT <br />i 95202-2M <br />T3 - <br />r -11i is 010 <br />i � :.t � � t . • :: s i s ^�r a. 3 • .e: ;k UrCi. 3. } 1 f: • "� k " t.. W. ♦., [•.:.. <br />• # # , • t r l.: � -r .,r .,•,z �}' th r >r�� rr � r r i. r � } r zs is <br />• . t+. ♦ . t <br />WATT441M♦ a. r ♦ S: k.. v t T wR 4 4 t >i f . tet. a ..� }i� i ;; <br />• documenting• • were a or will be a for r o <br />o Copies ofszWe resu1Wmvfifests/trmmng ` wi t a kf. ✓ 91 t • a t • :: i • .. , , s , iS. e . • photos <br />vefifying corrections. <br />1 ,.... 1 .rr;: g t.. <br />Inspection Date: /-3-2-o13 Inspected By: <br />Facility d SS: 1 `�io j- S. L,.a, A e d 1 ^j - Sri 1 c: t; jEp <br />I certify under ;dty of lave t: <br />inspection date. <br />III I have pemnally examined the Following documentAfion submitted as proof of compliance Ff"Ir <br />EACH VIOLATION and I believe the information to be true, accurate, and complete: I <br />* r, t t ♦ �, <br />a ♦ W t i; x • • a z t. Z --t.— r. <br />possibility of a fine and./or imprisonment for known violations. (HSC 25191) <br />Nanta: C,Nj - 'I 14CAjt Q461V Title: P&f-;, sya- - s -L -r <br />r <br />2`l;�T 5i 6&j46 VLtEA 4p, t,.jeEK QT 7-3-.2.013 <br />