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Funeral Director and Local Registrar Disposition(s): CR/Scatter Place of Final Disposition - Name & Address: Scatter at sea 3 miles off Half Moon Bay Coast, San Mateo, CA. 94403 Date: Nov. 14, 1990 Signature of Embalmer: Not Embalmed Name of Funeral Director (or person acting as such): Chapel of the Chimes Mortuary, Hayward License No. 1240 Signature of Local Registrar: Carl L. Smith, M.D. Registration Date: Nov 14, 1990
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