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SERVICE REDIIESI iSERVREe) Revised 11I1M <br /> FACILITY W RECGM83LLINS PARTT T J W <br /> FACILITY HARE )( l ur-m�-F 0Ac)ccj Sery�Lx- 1 -LI <br /> 577E ADDRESS yK l03`4 ne— -`V fix_ AUS <br /> CITY , [1 <br /> Tf\ „-T e A !' CA ZIP <br /> QtftRAMATDR X U v� c�r�7� l .CN Oar SOV\ RILLM PIDRT T R <br /> CeA <br /> DeA PHM An <br /> AJpeEss K Q 0 c7f�11 C,ra w Caen 1 a r�,r%s; lD�or I Px apiE rz ()r <br /> CITI ]C S .T. STAVE�_ 21P <br /> APR N 4ra:ue __.___ BCS Dist T My Code - - <br /> CJATRACTON end/era <br /> SERVICE W'KESTCR `1n <br /> -Aro L7 T ! BILLIM PAM Y / O <br /> DNA _ J oC Nlu �aJ <br /> RULING ADDRESS q �rCFAX it �•�_) <br /> CITY 7r STAiEIL tiT 21p, 1St O <br /> C <br /> BILLING ACKBpILEDDENERl: 1. the undatslirei oww, eperatw ar Molt of tee, tanto cdgs that all site aod/or project epe6f,e <br /> PNS 'D hourly charge aetncfsted with this fxilftY er MCIVIty Will ba billed to, the party ldeptified M the BILLING PARTE on <br /> Pegs , of this forty. <br /> PAYMILNI <br /> I also certify that 1 1wTs prepared this aiplicstian and that the Werk M M perfdod will be dtkr'in JaAatT�llag with Ill SAN <br /> JntDUJR C",Y ordinance Codes en(dJgee A sttateJ/and <br /> I isdanl lass. APR 2 4 1996 <br /> APPIJCANT't 3iiNA7lXE : \ =!%. ',/����. SAN JOAALT I,• <br /> LIC HEALTH SERVICES <br /> Title: (rat 10dfr�7 pata_T�� IRONMENTAL HEALTH DIVISION <br /> AUTPM12ATICE TO RELEASE IRFDRIYLTUM. In addition Le the at»>re, when ppplieahle, 1, the w r, operator w agent of sea, of <br /> the property tocatsd at the above Bite addrepe hereby outhariie the release of any and all rewtM Deotedllical data orKVw <br /> onl(rcraemaLlsite aefa6oslnt irtf~"m to SAN JOAQUIN CMRITT FURLIC REALTN il~RVM ERVIRMMNTAI WALYN DIVISION as aeon as <br /> It is steeltable and at the same tim it is prwlded to M am. Ay repreeasatiye. <br /> Nature of S r Ica Redpestt A) D1,jeEVL Z sar.;x coda D 31/ <br /> Assigned to Employes it nett f, J F6 <br /> Dote service Caopleted / Further Actisn Rtguir*& OT I N RENT 2- �O <br /> Fee Manx Anelnt Feld 01 v: e} illi t Repent Typo Bsesfpt I Chao! i Recvd By <br /> REN �!� $IIPY ,!^J ACCT <br /> Ck1" o '044g7 • — �¢ efd `f/�5(q(p wvls s est-sal <br /> Clr <br /> 01aas¢ Ingo . 4ec( 5 "olte . <br />