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SANJOAQUIN Environmental Health Department <br /> —C0u',:T <br /> Site Location: SR#or WP#: <br /> City: Date: <br /> `f X gs , <br /> P <br /> b A 6-f5 <br /> v <br /> N <br /> 1868 E. Hazelton Avenue Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />