|
7
<br /> ' � ► e jr.
<br /> �I
<br /> AN 10M,41IN L(i(,AL- HEALTH I'}lFtl(l
<br /> 11 fl-' . Hazelton Ave. , P.G. Box 2009
<br /> (209) 46:3-3425
<br /> ,lo,4j. '.11i:,, M.D. Hira1th Officer
<br /> TFC IPl_4,3
<br /> AIRC li I l t'AiJNfiAC:I l
<br /> TRIPLE S [RUCK FRAILER REPA I
<br /> A:,7"()() lWi F.%,1 r_rj► RU 4,,;(j(i -WA I-F RI.►_rl.i R0.
<br /> CA 9.5 S STI't(:;E<::Tt N, i"A
<br /> Hi I 1 inn St.,t.prrlent• For 1' ; Per(oi t•, Underqrourid T iwik: Facility.
<br /> Statement Oate ; January
<br /> F`:;y ,rtrl • lii.��:, `il�' ; Fat.+rh,,r�'
<br /> Facility Fee- 100.00
<br /> Container Nurr4l_,ei- ; 0001 50,00
<br /> k'
<br /> ,
<br /> 7.1
<br /> ii• ; 4�1 .". 1� f4. A ^7 '• +1t •},FA tV �f
<br /> s , ,p�, �p1� it , ► ae t Y� r,'r +� 3+
<br /> 31,
<br /> Ebb,,.. '�•.0}3�
<br /> ��# `f' kp r�'1`�4M = 'r• �:.•'.,•1 y �`' '
<br /> F .IVI�T.� �•I` il. ! � .1"... ���• � .. ....r,}�5,� .r} y .w��,�+u i.'{•• �.. iyl .f,Ik._a.. ,. i �'.' „�.�^+ .
<br /> N(,,.; f Y t•fti
<br /> !j.•-,i €ir l71= C ,,F sial)'
<br /> waif Y,-
<br /> c..c I
<br /> ,ec"cI 1g..',T1 r rpi!A. of
<br /> r� syrl7 sit.
<br /> an'.] apr:,rclval of
<br /> f
<br /> 111 t-y .
<br /> keL-Uriw payrfier1j• aloin,y4 wli.ir iirlc
<br /> coy ,rlf t.}1} �f.at .r,,,: ;lt• t.,aF;
<br /> c,f�lJ •1f.?As'�rl.�:Elf L.Cr�.►=tl_. HE•ALIH D�:_-'.TRIC:�i
<br /> (--'NYlR'."f��11=�tFAL- EiFAt_Tkl PERMI113E:PVIUS
<br /> will he aciiir• d after.
<br /> PAYMENT
<br /> RECEIVED
<br /> 1 o0% of F ase Fee
<br /> FEB
<br /> 1. � fig;•�.
<br /> NN�11/1RONMENTAt H
<br /> PERMIT ` � �A
<br /> `�f#
<br /> j � E,tvIC_L-�
<br /> F
<br />
|