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0 02-22-1996 03:59PM FROM V TO 14159762452 P.02 <br /> o��BaCv <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES - ENVIRONMENTAL HEALTH DIVISION <br /> HASTERFILE RECORD INFORMATION FORM EH 01 15 (CWNFAC) Revi• 5/16/0; <br /> �V FACI IITT CHANGE OF OWNER DATE OF OWNER CHANGE _J / INACTIVE <br /> Prior Owner <br /> i <br /> MDER CONSTRUCTION ! CHANGE OF BILLING DATE OF BILLING CHANCE / /_- DELETE <br /> i <br /> OWNER FILE <br /> MER 10 �` j�/�/n ,�,�I ,, CASE f BILILNG PARTY Y. OWNER NAMEl.I P 4 U7"VlN-Y OWNER HOME PHONE C ) <br /> OWNER DBA OWNER WRK/BUS PH <br /> ADDRESS <br /> CITY ._� gyp'/��, AAav�(C� STATE 2)P <br /> HAILING ADDRESS 74 h19'[J.-P <br /> CARE OFE(OL AA <br /> CITY STATE ZIP <br /> BUSINESS CODE NATURE OF OWNER BUSINESS <br /> FACILITY FILE ••'_ <br /> FACILITY IDR <br /> FACILITY NAME ;I rV51LS1��/4� T7'Y9(C.LOF TRUSTE LANDS?ES Y / H <br /> FACILITY ADDRESS " ��F �,� b 1 F W✓LQ,/U HOME PN (. ) <br /> CROSS STREET / BUSN PH ( ) • <br /> CITY STATE ZIP <br /> Census f�-/--l-,�-•--`1•, BOS OI/SE: Location Code City Code •-••••----- <br /> NAILING ADORESS l /VVL:. 1/�V�{{O,II,�,y�C T( )� ,�:�'Y�_ APR 91 <br /> CARE OF _L Lc.CJ .T. V(�}ci i!� SIC CODE <br /> 17 <br /> CITY il/l(I.l�/�; � SYATE ,rA- 2IP <br /> / - <br /> GENERAL TYPE of BUSINESS At this FACILITT <br /> UST FAC STATUS CODE BUSINESS CODE BUSINESS TYPE (UST) <br /> iy1RD PARtY 81LLfN INFORMATION <br /> NAME I HCME PHONE <br /> HAILIN$ ADDRESS \ i ',�-'• _ BUSH PHONE ( ) \ <br /> CARE OF _ • hIg@ IUA <br /> CITY I STATE 7TP <br />