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COUNTY OF SAN JOAQUIN <br /> e; .c ACCOUNT NUMBER <br /> 2 <br /> OFFICE OF EMERGENCY SERVICE <br /> ROOM 610, COURTHOUSE <br /> -i 222 EAST WEBER AVENUE "�• I <br /> c4<;Ros'`P STOCKTON, CALIFORNIA 95202 <br /> 61 11.. <br /> R - 8 1992 u <br /> BUSINESS EMERGENCY PLAN FEES r <br /> BUSINESS NAME BUSINESS PHONE NUMBER <br /> CENTRAL VALLEY FABRICATORS <br /> BUSINESS CONTACT NAME <br /> CLIFF KENST <br /> BUSINESS ADDRESS c» ». CITY STATE y.s,a;;z... ZIP <br /> Tull r_R 95, <br /> BUSINESS EMERGENCY PLAN TYPE: LONG $240.00 FEE PLUS ` SHORT $60.00 FEE PLUS <br /> ❑ FORM $15.00 PER HAZARDOUS MATERIAL/ ❑ FORM $10.00 PER HAZARDOUS MATERIAL/ <br /> NUMBER OF HAZARDOUS MATERIALS: 3 <br /> AMOUNT DUE • • <br /> + 3 J( 5..15.00 <br /> FEE NUMBER OF MATERIAL FEES <br /> HAZARDOUS MATERIALS <br /> 04124192 • ' • <br /> DATE DUE: YELLOW • . FOR YOUR RECORDS. <br />