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' ' PgUIN • <br /> �0. 3.co COUNTY OF SAN JOAQUI(y ACCOUNT NUMBER <br /> r.' y <br /> a _ OFFICE OF EMERGENCY SERVICE 1774 <br /> ROOM 610, COURTHOUSE <br /> 222 EAST WEBER AVENUE i. <br /> . ;05 c • STOCKTON, CALIFORNIA 95202 r�----- <br /> FEB I 0 1993 <br /> BUSINESS EMERGENCY PLAN FEES <br /> SAN J)AQUIN COUNT <br /> OFFICE OF FE17R6ENCY SERVICES <br /> BUSINESS NAME BUSINESS PHONE NUMBER <br /> CENTRAL VALLEY FABRICATORS 209-948-6448 <br /> BUSINESS CONTACT NAME <br /> CLIFF KENST <br /> BUSINE ADD S CITY STATFA 2195205 <br /> 1 0 E YPNCHOT ST STOCKTON ff <br /> BUSINESS EMERGENCY PLAN TYPE: ❑ LONG ❑ SHORT <br /> FORM FORM <br /> NUMBER OF HAZARDOUS MATERIALS: 3 <br /> AMOUNT DUE • • <br /> $240.00 + 3 X f 15.00 _ $285.00 <br /> FEE NUMBER OF MATERIAL FEES <br /> HAZARDOUS MATERIALS <br /> 03/05/W WHITE COPY <br /> BE <br /> RETURNED •UR REMITTANCE — <br /> DATE UE: • • • • • • •R <br /> r <br /> - 1 1 toCL7 -1 v .bL C vs vc, <br /> RECEIPT BUSINESS NAME CASH CHECK OTHER AMOUNT <br /> DATE NUMBER ID NUMBER PMT PMT RECEIVED <br /> RECEIPT NO. 10605 <br /> a <br /> SAN JOAQUIN COUNTY <br /> OFFICE OF EMERGENCY SERVICES <br /> HAZARDOUS MATERIALS DIVISION <br /> 222 E. WEBER AVE. - ROOM 610 <br /> STOCKTON, CA 95202 <br /> BY <br /> CASHIER <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 /> CSJIOES-01 <br /> RETURN WITH YOUR REMITTANCE <br />