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~ENATOF~ BLDG. NO. 225 <br /> ~-~.0 ~r~y~ ~]'RT~%'~ ~Y~ <br />,~ALEM, OREGON 97301 <br /> <br /> PHONE:,E88~5147 8:00- 4:30 <br />· 2~ HOUR OODE-A-P)-)O]~]~! .5~-79D4 <br /> <br />DA TE: ~.~ <br /> <br />TYPE.' Dt4-~ZTE SE~GE ~I~TEE SUPPLY: <br />PERHiT G~ APPLZC~TZB~ NO: 5gene 5.[TE <br /> <br />ST(~ND~RD OH-S~TE SYST~-.. <br /> <br /> <br />