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COUNTY OF SAN JOAQUIN ACCOUNT NUMBER <br /> Q' OFFICE OF EMERGENCY SERVICE <br /> 1930 <br /> ROOM 610, COURTHOUSE <br /> ' 222 EAST WEBER AVEMIE <br /> - C9l�FOR�`P • STOCKTON, CALIFORNIA 95202 <br /> D p <br /> BUSINESS EMERGENCY PLAN FEES FEB 161 -- <br /> jL&1SINESS NAME BUSINESS PHONE.NUMBER.. <br /> OURRFLRt1E 8 2005 WASHINGTON ST 209-547-2660 <br /> jeBUSIN ESS CONTACT NAME <br /> JRNES R. GONZRLEZ <br /> BUSINESS ADDRESS CITY STATE ZIP <br /> 2005 WRSHINGTON ST STOCKTON CR 95203 <br /> BUSINESS EMERGENCY PLAN TYPE: ❑ FORM ❑ FORMT <br /> NUMBER OF HAZARDOUS MATERIALS: 2 <br /> AMOUNT DUE • • <br /> $240.00 + X $ 15.00 _ V,0.Go <br /> FEE NUMBER OF MATERIAL FEES <br /> HAZARDOUS MATERIALS <br /> w=:r. 03/05/93 WHITE COPY MUST BE <br /> DATE DUE: KEEP YELLOW • - . - YOUR RECORDS. <br /> C�- <br /> Oa!e <br /> Pay Apar. M/aHOK <br /> YOaSpr L <br /> f=.' ! A`.:OUNT DISCOUNT <br /> If you have any questions or wish to discuss the calculations, please <br /> call 468-3969 to make an appointment. <br /> Thank you for your cooperation. <br /> CSIIOES-01 <br /> RETURN WITH YOUR REMITTANCE <br />