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APPLICATION FOR WELIlPUSIP Li`l' <br /> SAA!JOAQUIN COUNTY PUBLIC MALTH SERVICES <br /> SWROAtl4 MAL HEALTH CIVISMN <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 55202 <br /> (ZM 468-3420 <br /> MMnW_nt E! <br /> ft"Wo In Trb*EW <br /> MMATM7M fS MM er MACE TO ttE aAn IOAiP_eN�pplrrylrYN!A Pa"F TO L•OMSTRVCT AlRfNR MVetAtt Tfe!14L7R oEdtlQ!!!O.TNM OFFMATM M MPDS Mt COM IUM=VMh OAN <br /> , <br /> AACLwtCOiRRY SEVgAfMN�'[TgIL[.TH#T6i -f f 18.E 1M10 TRE MTMIOMMe Or am]oAOIAM vmWV ftmE MM.7M f b.{MY FMAL MMM dMwiW, <br /> 750JtrO AOwIMlAAI ATW FOest Lake Rd, ar ALaiAQ. Ca 95220 <br /> PAAtxt>iAEMiwI_ <br /> Joe $ger — , . 1277 E.-Pettier Rd Acar#&QR CA 95221Y <br /> r�trrAAcraR Purviance Drillers, Inc. . P033ox 64,Lindenue, 377923_, 887--3554 <br /> } mm CORrAACT011 AOM" tic- R O Ni P <br /> I <br /> 1 a 0+Paf.fmaaa.mac• � <br /> 13 RfarAefnrTerf 0 TMBumnEv n © r r <br /> I _ a f wof .* ".-2.5— n4er rrnr:n a <br /> 6T+tdr rtllA/l <br /> 0 Gw4"ftivlmwm ❑Wav"rslcAl VML F © efnl.mtp s <br /> I7 <br /> '13nanverrcn ldemrTrtis frr ora+acExe�rATfar rorcmr�ccrvrcie� a <br /> i3 DDmw cow,m 134mm VAef mm_ rrreo,CAewOAfTt7E Anon VML OF VML CAw a <br /> W sem Da in OWN lMltt9TAttMET 91417!RFAW E <br /> ❑wewfRRwM WMT WA AWM;91:I3Yr 13M. CdfC[O7t PMXWTALRr OMnMQYw 1301. 9 <br /> ArrRgt,eePrll Lo�sslrrs Cw*"181NMK"RPF A <br /> rIWFOem CO>tilR71CTISiMO1sllOffirMf110Ds mwwTw AmmrAsK AMOER oTHffL_ <br /> VMAX%r-4"=Aan YM17 WM liCc sECQ9&ssl iw�YE:is ipw . c0•am srnsa sR�,�'7 Nino AM <br /> �aulA<*lofw>7PTslE:.rf�oAoow+�rv,flOeeeOwl�OrIb�AOflff'1 wwMlTplt Oeiriaws7RlrOMWIesIBi��TwtTwTrePeAar�aM�a�e.wwcrortws•en <br /> Tw Famf myleum TNV=jwvw vomowNSORRCrT41Y6111Gr4r'S1.YJIVIMMYw7PtRr1.UfCAtlor�lre•CEIrrMCrOrf71e1w19DA7M!•OORIIMICCfMOEIOMIITUwC4lRlrl!/� <br /> aM jo '1 a1TMle?MM WiCE oP!fE wawc iawMsnCN rills rewWf tE49SUM rwl ENN% M 91— SUMECr TO WOR W A M OOMPOMOM ,I OF <br /> �MlsmreA.- +ur►aaNswlwrawia►+aawwinrwsRw4twiu+aP.raaraas..x�wts+iaTl�+FrtsxstaTr®s�ea,rNal�m. <br /> „ ,� !.4 tray r•� Corporate Secretary <br /> +.fOMiff or erfREre OR RVAn"lfeA>w.r TavRsoRma TRE rrlesavtrx iof:ATbfsor Borrie eflssos owfoea uYlrrwiroR rrwfveta <br /> e.0111 m OP TRErrorm".amm ar swomm unto M.overem <br /> @/f \1 i.YrMkMROReD OMPM AM tO 4UM OP JM elUMM AMM"M s.rCGTTOn(WIMM iWnwo emM*row 17. <br /> irTeA:TylEt,s�dlM.IOCOY9eM Affils eotfr AiMfTO;O AYe,Afar WMM OfrTrMrM0lM MADAMM1S we7reRlf. <br /> I <br /> QA <br /> 1 <br /> !F► ... <br /> r <br /> D {+s <br /> I <br /> � �., 4Q4wgreer vVe eOk7 o.r D'a E'JMr y"L7�./f 4t ��`� <br /> f AArsa`sirf Awr1n,6 or <br /> joe.inne.�.ttieluee�er a� . <br /> ACcallAawt'41 seaF PAa/ <br /> r/teO!' !!!WO AMWW MMOTT® 1HO6vb rY DA" RIYOiCi <br /> p 65aO•Gip rt[R r <br /> ----- <br />