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~ . <br /> Date run 2/13/2014 11:48:57A[ SAN JO UIN COUNTY ENVIRONMENTAL HEA1 I DEPARTMENT Report#5021 <br /> Run by Facility Information as of 2/13/2014 Page2 <br /> Record Selection Criteria: Facility ID FA0004175 <br /> BILLING and COMPLIANCE hourly charges associated with this facility <br /> or activity will be billed mthe party identified as the OWNER on this form. /also certify that all operations wil/be performed maccordance with all applicable Ordinance Codes and(or Standards and State"ndfor <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: oan, <br /> Program Records mueTeAmupsnso: ~$usoo~ Amount Paid Date <br /> Water System mbeTRAmGrsnso: Amount Paid Date. <br /> Payment Type Check Number Recei <br /> ne*a: ooe, Acouuntovt: oovo '9 lcw <br /> commswro. <br />