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Pt,EMC 42ALTH SE" `"S, SAN Jk:RQUIN MUNTY <br /> i CGi E. azel ve., P.O. Box 2009 <br /> tocktGrj, CA 9S2,01 <br /> ii09) 4118-3'425 <br /> Jogs K€area, M D., Health Off icer <br /> PIENA20 <br /> P I E P,WIGNWIGE,, IAC. P I E NATIMIDE, INC. <br /> 2007 3. WILSM WAY 2(W Y. WIL`K WAY <br /> STOU"FM, CA 55205 STOCKT04, CA 95205 <br /> hl irg Statos,*,it For 1 990 Pern.it, Unix'-grourid lank Facility. <br /> State, rpt Gate , January 2, 1950) <br /> Pay€e�;t Guo G¢tet F :iraary 2, 1990 <br /> Facility Fee: 100.00 <br /> Container i311'�ue�t �CaJI �}.0 <br /> TOTAL FEES <br /> tbTEa, <br /> notify Public Peal.t) 'Services, <br /> Sari Ji�aazr Ccortx of any <br /> correcticrrs or changes <br /> necessary. Your p2Tttiv will <br /> be c:ailed upon receipt of <br /> payrieiit and approval of <br /> facility. <br /> Return PaIvmertt along With One <br /> copy of this statef*nt t , <br /> 91B IC KX-TH GERVICE'S <br /> SA"e 3rMWIf# GuNJN i Y <br /> P,'V1WN i` T'AL HEAL k' PERIM,IT/SERVICES <br /> P,O- WAV 2110 <br /> STGCKTU1, CA 99201 <br /> Peniel ti es wi 1 be aid after <br /> due :fate as s4rwp; <br /> SES dily5 !W% Of Brie FEIC- <br />