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MAR-17-2006 09:34 FRDM:STANDARD PACIFIC 9258479167 T0:2098350675 P.002/002 <br /> son Joaquin County Environmental Health Department <br /> GREEN FOAM <br /> DATE -��' MASTER FILE RECORD INFORKATION 'AMFe <br /> Orrr m ate* e«>At U �� <br /> CWIFM RILE <br /> L�IEc*Tf OWfN��Cs/R+t�ntroNt�Arw7al EHiY <br /> PlL78T>~IEA71LO1N?lIIG' O <br /> Pttap rltrY Owta�n N+tra r✓ ` Too <br /> Mt Last <br /> SUO[WIRSsNAME ��a,.,dQrd Psi�ie o f Alac�kecrr Ca tc►r n i q Soas>C TAX T,OP <br /> owner Hame AddrWa B .S H o p y wrd Road , Svc �e J 4 5 DRm�rltLtt l!ItSn aT <br /> M' P Ie,151k" 01"I sTATn Iv'A " 4'�S BR <br /> Owntar HARMS AddrA" `(L�S q 18p° <br /> Melnt►p Addt+en City <br /> Soft �R <br /> CCIRMRATIOR tmmrouw rJ PAR7mgrlr m Fee AuENCY Q tm m Cl <br /> FACILITY PILE <br /> AOM"T ip d [N1ItG <br /> ItAOLM xb.as / � 1 t g CltosR Rrr ID 4r <br /> wv &S.JrA�. <br /> Is this a Nrw Swina m LmT[oN not prtenlOUSIY reSlttIAW by the eNVIRONMENTAL HEALTH DEPARTMENT? Y" ❑ NQ 11J+ <br /> I.S t4tis an e5aSTMa Rwtntls LOCATION but a NEW T M of MulabdQ suaines� YM NQ <br /> BUSINIMIFAMIRY/SmNAMrr � e <br /> We ate b ¢ <br /> AUMUM / BUM* <br /> 1SU9tNtt�PNQNI <br /> e v�4 <br /> Tt-rxt S"""'CA ' X53760 <br /> pa nlr or8nrr1!S0*Ds9rtttt r I oaTxon <br /> ctacoon Prl Krf2 <br /> Marring Adillmstt 1rDdfFrRBYrft-ArcWAddlvxs Attentlor:or CttreOf(glMUW) <br /> MalllttpAddtimOty� y� $YATL' ZIP <br /> SIC r na I1�S C�Ft 'ILI :A"0 <br /> THIRD PARTY Sn.�li.a info--. Complc if Billing'party !s d1J7t?renf f vm Properly Owl t:IrFa a:ity ort per for dmWW ab0w <br /> ovxma%t Most <br /> Ptttatre <br /> Mnlling Addte" <br /> 57A'tA 1;If' <br /> Grty <br /> for lass and diarges OWRM FACKJ Y1B1JS1NFS$ THIRD PARTY BILLING <br /> nrr'i.ir A �`aMr+i i rR A!`XMM�IIIITAIWt j1,the andaralgned Appllr;nt,ccrtlfY that]ATE the Oroner,Qjmrov,or dadwrkmiAArnt�Tadt flusAm*r,eaA I adlmn�wtadgn th■s.n 3'6xatrYl�tRd, <br /> J',RNALTrR6,RN RCxaw C1reer,Rc antlMr}lnuRLT Crt�rvrS nlanelnted with <br /> rills oparatlon will la,blllad In and at tbr.add trxr Identlflet) ne tfia d 'tilt!pta,1 Also rartnty thM <br /> Rif IerStrmntimt prtwldaA sole npplleadon h Iran AAd terra and rb■t nn rrpalRted atdvlHat will be performed la Arderdnncn rekh II Nenblc$hN1on,QUtN CQLSItrV Orflln■nr-r.Cwidct end/dr <br /> Stnndwrda and Srwoleg <br /> TK An Fr; ,ttnt.l.pwr nhd Rrolmlaw.As the tmdmdgned owner,oprrnmr,Ar atttnt Ortdr l r�Y Iacatrd the efi nhd111yleNr mldreaf.l hM�hy evlhnrlae Into inia I of <br /> anon ar M . 1AUle Amt wt rho some tMbo It In <br /> any and eR rein ttf an mental ae 1.In(om"d.n to FAN JOAQUIN COtrvTY ENVIRONMENTAL IiFALT11 1' NT�• <br /> proM. 10 Mr fir ""V I <br /> APPILCANI NA 5l/1s l IGNATWRE Q <br /> TME /�/4 ), — ' pFt1VRRS 1.>CENSC A' -P <br /> ('v�/ rN(►f'�t:Ut"I R>:t7V1'Rpo) <br /> Approaed Of troop. AamtsK1nt101flbe Pmtaaeln0 Chmplabrd IIYLIS IO <br /> 29-02-402 April 25,70M <br />