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Galaxy Rental Center Gerald W. Wilson <br /> F <br /> 6TP.EET ADDRESS -- — SITE PHONE I WITH AREA CODE <br /> f � 1155 E. Bianchi ( 209 ) 477-4404 <br /> Y CITY — STATE IIP CODE I of Tanks <br /> Stockton LlCA 95205 rat Site Two (2) <br /> A APPLICANT/BILLING NAME APPLICANT CONTACT NAME <br /> P <br /> P Western Meter Service Wesley Dubose _ <br /> L --------- -- -- -- - --- <br /> 1 MAILING ADDRESS - APPLICANT PHONE 1 WITH AREA CODE <br /> A 2735 Teepee Drive Suite E - -(_20.9 )948_6124 - <br /> N CITY STATE UP ODE TYPE cf APPLICATION <br /> T StocktonT CA ( <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> _1li1 AL W[ <br /> OFFICE USE ORLY <br /> wmtiM MOWN 101 <br /> IW�VVRI��IVV9 VDVVVV�IVV�IVV�IIM DI��IVVVVVM�VIIIVVVN�G IVVV�IVVVI IVNVVINflIIVIVVVO A�VVIV®V <br /> SWEEPS I COMP 1 LOC CODE 01ST CODE AMOUNT DUE AMOUNT P.CV 1171.151 1111 BY DATE RECEIVED PERMIT t <br /> jaz3 GMK 09 z <br /> X <br /> !�@VVVVV �VN!VVVI�@V4@II . Rl1bV��9V1�IC�147.1 VI!IIJdVVi�VVVVIMIIVIiVV VIR�VVVVVV(,iVIIVVMIVVVVI d1VV�MVU@I�VVVVV <br />