Laserfiche WebLink
.i <br /> COUNTY OF SAN JOAQUIN <br /> REFUND REQUEST FORM <br /> DATE: April 29, 1992 <br /> DEPARTMENT: PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH <br /> REASON(S)FOR THE REFUND: OVER PAYMENT OF 3459,APRIL 16,1992,CHECK#58931,FOR UNDERGROUND STORAGE <br /> TANK FEES. <br /> ST JOSEPH HOSPITAL, 1800 N CALIFORNIA ST <br /> SAINT18 <br /> RECEIPT Y OTHER IDENTIFICATION / <br /> DEPOSIT PERMIT E DATE OF DEPOSIT PERMIT: <br /> AMOUNT OF A9FUND $'4B8 ' <br /> ReF�NQ',F�,�'AI�NC'►o:,"€T�iI,S��i�rl���P17A�.. <br /> ADDREGGi_ CIO ENVIRONMENTAL HEALTH <br /> 445 N SAN JOAQUIN <br /> DEPARTMENT APPROVAL \l/% <br /> A I 6lprulura <br /> EXPENDITURES AUTHORIZED BY: <br /> AuthorizW 61pn�tura Data <br /> ABATE,TOt 1?1000-01nrQA 00. 6140 0006 <br /> Claims examined and <br /> approved pursuant to Govt <br /> Code Sec. 29741 <br /> 9 •/ ADRIAN J VAN HOUTEN <br /> County Auditor <br /> by <br /> Deputy <br /> ENTITY NO FUND DEPT NO EXP CODE AMOUNT VENDOR NO <br /> AW Cont-291609) <br /> �I �I <br />