Laserfiche WebLink
Fit ype of 111 fill,, <br /> ) t.oca1 10 <br /> ,/ _) Stale IP -1 C11.v cude 4) Facility <br /> Stat - <br /> A Program /Element code �, �Isr / <br /> Owner Info l 7) Name -- TLC'_Y£�GSyU LT- ___�0rZ7gZ7l�j, <br /> B ) Address __2t --G3--&0dM1 S - <br /> -------------- <br /> 9) City. St10) <br /> --------------- ----- ---- <br /> 12) Public Ag -- <br /> Fac Info: 13) Name --� `-� <br /> ----------------------- <br /> 14 ) Address - ----- 15) ----------------------- <br /> NC? <br /> 16) City, St <br /> ---- --- --------17) -- 181 <br /> Billing Info] 19) Bill Name ----- <br /> 20 ) Bill Address --------- ----------. ' ______---- <br /> 21 ) City St ---3A_vl4 - ---22) -- 23) ----- <br /> 24 ) Phone - ,& A ��� <br /> Fac Type : 25) Fac Type d!26) <br /> Con tac is : 27 ) Day Phone -rll_-- ?� <br /> X91 Night Phone —----- rhl - -------- <br /> L) r.< C.,, r - 1- - 11 h< c.tr / •j,/r�� <br /> 11 Tan ID r 3 12S'�}�c2ol TI T" ID o 1= /./l/YY 1) T.Y CDtr <br /> • <br /> 11 Gtr ry,. O• 31 C.tl Trp. -o I 11 C." T <br /> )1 .111 Trp. iftl��qq 51 .Ir1 TIp. L�q 51 Y1r1 TTp. L`+ <br /> .1 C., (..1 ) -/�V V- D <br /> /� Q/ tl C.p (tall U C., 11.11 - - - <br /> TI W..' ar. — .6 1) Ywl YI. <br /> t1 Co.l Yl.t -191 it Cwt Ya.t Al TI Cul rt.l <br /> II r.< C. • - / 11 I.< C. • - - - - 11 T.< C.Ir r - - <br /> 11 T.. ID , 3r/1 y�f�Y -//J-710 T) 7M ID • - - - - - - _ 11 T.. ID a . . . . - <br /> 1) C.ar T,p. 01 <br /> 11 C.tr Trp. - - 1/ C.1, Trp. <br /> - - <br /> a) rirl TT".. O• a) rill Trio. - - 11 11tr1 TIp. <br /> a) C.P (c.l) v-�- r) C4 (call - - - - - <br /> a) Cy (c•l) <br /> TI r«ta,. - D 11 r«t •rc - n r«a ar- <br /> e) C«t aa.i �/ a) C«i ■a.a _ _ a) C«t at.% - - <br />