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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES - ENVIRONMENTAL HEALTH DIVISION <br /> MASTERFILE RECORD INFORMATION FORM EH 01 15 (OWNFAC) Revis 8/26/93 <br /> NEW FACILITY <br /> CHANGE OF OWNER DATE OF OWNER CHANGE / /_ INACTIVE <br /> Prior Owner _ <br /> UNDER CONSTRUCTION <br /> CHANGE OF BILLING LATE OF BILLING CHANGE / /_ DELETE <br /> ']�, <br /> OWNER FILE m D 3 a'S(/jO <br /> / D Q� CASE q BILLING PARTY Y / N <br /> OWNER ID GQ O <br /> �( OWNER NAME Ame!!Ican Stores Properties Inc. OWNER HOME PHONE ( ) <br /> �+ OWNER DBA Not, OppliC'able OWNER WRK/BUS PH ( 801 ) 961 - 5776 <br /> 136 E. South Temple Street, 11th Floor <br /> OWNER ADDRESS <br /> OWNER CITY <br /> Salt Lake City STATE UT ZIP 84111 <br /> MAILING ADDRESS P.O. Box 26948 <br /> CARE OF Barbara Russell <br /> clTr <br /> Salt Lake City STATE UT ZIP 84126-0948 <br /> HUSINESB CODE NATURE OF OWNER BUSINESS <br /> FACILITY FILE <br /> FACSLITY ID # �/_ BILLING PARTY Y / N <br /> -{v-�� # OF EMPLOYEES <br /> FACILITY NAME TRUST LANDS? Y / N <br /> `I � • _ <br /> FACILITY ADDRESS �JeSt L�oj ( / > HOME PH ( ) <br /> EDEN PH <br /> CROSS STREET <br /> CITY L STATE ZIP <br /> BOS Dist Inc I:aion Code Q 2- City Code ----------- <br /> Census --------- DDl-{ <br /> 29. 0 YY)" YVI eu O <br /> APN # <br /> MAILING ADDRESS <br /> SIC CODE <br /> CARE OF <br /> CITY STATE ZIP <br /> GENERAL TYPE of BUSINESS at this FACILITY <br /> UST FAC STATVS CODE <br /> BUSINESS CODE BUSINESS TYPE (UST7 <br /> THIRD PARTY BILLING INFORMATION 6M',�y IClk I I <br /> MA4E Montgomery Watson 1. �( rY HOME PHONE ( ) <br /> MAILING ADDRESS <br /> 365 Lennon Lane � � �LQ Y� CA EDEN PHONE ( 510 ) 975 _ 3473 <br /> ARF OF Terr Winsor <br />