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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave.-Phone : 466-6781 <br /> P.O. Boz 2;u9 Stockton, Ca. 95201 <br /> ❑ Approved <br /> [� Approved with o:Laavee : See Remaxks <br /> ❑ Disapproved; .,See Remarks <br /> Remarks <br /> Date "�. 5, <br /> Approva'. of tl-ese �A.a:-A ortends o: to <br /> that wl ich is 1 hox,i nn;l deocribeu trere- <br /> on but does not autho:-1-o or approve <br /> vny omission or deviation of require- <br /> -nts of State laws or local Ordinances. <br /> �kgx�tcTC©PYO (C4)/(�¢z4i�1�Du�j(Vt1��TLlt� l�FS�FD2T� rCDcl�c� TZll � <br /> oMJ�y -TJ4(.17 Or-T <br /> � ��5 iZkK� ,�� A-t� Dcof��Gz'S�co�crt�cToc2(5 or�7ta�� ,' <br />