My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
BILLING
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
H
>
HUNTER
>
240
>
1900 - Hazardous Materials Program
>
PR0519579
>
BILLING
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/17/2020 10:15:08 PM
Creation date
6/9/2018 9:28:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
BILLING
RECORD_ID
PR0519579
PE
1920
FACILITY_ID
FA0009362
FACILITY_NAME
JFD RETYRE INC
STREET_NUMBER
240
Direction
N
STREET_NAME
HUNTER
STREET_TYPE
ST
City
STOCKTON
Zip
95202
APN
13913002
CURRENT_STATUS
Active, billable
SITE_LOCATION
240 N HUNTER ST
P_LOCATION
01
P_DISTRICT
001
Supplemental fields
FilePath
\MIGRATIONS\H\HUNTER\240\PR0519579\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
4/5/2016 10:07:29 PM
QuestysRecordID
3029210
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
52
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
, ,. <br /> ACCOUNT TRANSMIT' <br /> ACCOUNT NO. LV1 f. NO. AT <br /> LAST — GUARANTOR — FIRST MI TITLE LAST — AKA — FIRST MI TITLE <br /> F 7&7 <br /> I <br /> C/O NAME GUARANTOR SSN <br /> I I I I I I <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> G ( q II <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> USER REFERENCE NO. BILL ST♦ CLE STATUS DATE M OB INT MONTHLY PAY AMT PYMT RRpB Di <br /> 3 , WE^^DcC4ITE TERM DATE <br /> I I I I I •LDC I I � <br /> CHARGES <br /> LAST — RECIPIENT — FIRST MI TITLE RECIPIENT <br /> DOB USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE: <br /> DATE OF <br /> START STOP MED REC NO CHARGE <br /> 9 <br /> .ARG DEPT NO HARGE <br /> NO DESCRIPTION AMOUNT NO DEPT NO DESCRIPTION <br /> Yae 1 1 1 1 I I <br /> I I I l l l l i <br /> II <br /> I CS F. 1 moo v 1 <br /> n Illlli ) <br /> I I I l i � I"rQSIC�P nt I ` I I <br /> I I I iI I <br /> I 1 1 1 1 1 1 1 1 1 1 1 1 1 I I I I I I 1 1 1 1 1 1 <br /> I I I I I I I I <br /> TOTAL In <br /> GUARANTOR <br /> DOB OR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZI C DE, J <br /> EMPLOYER NAME 'EMPLOYER <br /> lP HONE NO <br /> I I IL4 11 <br /> EMPLOYER STREET CITY ST ZIP CODE <br />:.I lc I 0101 071K 1l-W Id G I I I I 1 I IIC�G.I4' I� I I I I 2 i t <br /> SPOUSE <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> 1 ' <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> EMPLOYER STREET <br /> CITY ST ZIP CODE <br /> 1 1 1 1 1 1 1 1 <br />=REPAR 9Y CHECKED BY <br /> � DATE <br /> tB co L. za taiem <br />
The URL can be used to link to this page
Your browser does not support the video tag.