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G <br /> • <br /> ' in County. <br /> is <br /> • s <br /> lth De <br /> Partment Al <br /> R�/FoRa�P <br /> I <br /> 304 E Weber Avenue F #: ❑ (209) 464-0138 <br /> 3rd Floor, Stockton, CA 95202 <br /> Phone; (209) 468-3420 D (209) 468--8392 <br /> (209) 468-3433 <br /> FAX- <br /> Date: 16"/? Time: 2 `I 3 <br /> # of Pages (including this sheet): <br /> To: 5 �� FAX: <br /> Of: <br /> From: Voice Phone #: <br /> Re: f stn <br /> ❑ Urgent f For Review ❑ Please Reply ❑ Please Recycle <br /> Comments: <br /> STATEMENT OF CONFIDENTIALITY: The information in this facsimile is legally privileged and confidential information intended only for the use of the addressee <br /> listed on this cover sheet. If the reader of this message is not the intended recipient,or the employee or agent responsible to deliver it to the intended recipient• <br /> you are hereby notifed that any dissemination,distribution or copying of this telecopy is stiiLlly prohibited. If <br /> in error.plase <br /> immediately notify us by telephone at the number listed on this cover sheet and return the ori al message t�s at the abu have ove address viaved this 'United States Postal <br /> Service. We will reimburse your costs in notifying us and returning the message to us. Than You. <br /> EHD 4MI-012 <br /> REVISED 6r14-02 FAX COVER SHEET <br />