My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
F
>
FREMONT
>
0
>
2900 - Site Mitigation Program
>
PR0515453
>
SITE INFORMATION AND CORRESPONDENCE
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
12/11/2019 5:02:52 PM
Creation date
12/11/2019 4:21:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0515453
PE
2950
FACILITY_ID
FA0012156
FACILITY_NAME
NORTH SHORE PARCEL
STREET_NUMBER
0
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95202
CURRENT_STATUS
01
SITE_LOCATION
FREMONT ST
QC Status
Approved
Scanner
SJGOV\wng
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
150
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
12/08/2000 09:57 2094683433 FIFTH FLOOR PAGE 02 <br /> 2094683433 <br /> u Jaa oro Cuun, Public:Health:'O.Vices ;'.Environmental- h Division" <br /> GREEN FORM <br /> DATE MASTER FILE RECORD INFORMATION "MFR" <br /> MDLDaseA9 rppEHn YlltmLr ., ownnmta '] ci'3Edrr. S i' NIT IV <br /> 2-2 <br /> OWNER FILE <br /> CNKmff OWNER Lwxernrxsae wrnrEHd' <br /> OMPLETE THEALLOWNG PROPERTY OWNER INFRMATION: <br /> IRGMNnYO.st -R6WMf4 �A 1, PHQNeqw_K0'0 `O <br /> NAME <br /> `. <br /> �/^� ^ First Nt 18af <br /> SUSINrSS HANE7/,1� 1/� PrP <br /> Sac SELL TA%ID# <br /> 9wner Home AdddressersE♦ /���fECllrA DRtvER's LXINSE 9 <br /> � �� <br /> city On br STATE eA ZIP � CL <br /> caner namtpAda[as �/^� w A RR��rt v <br /> Nailing Address CityGy,NDS smtQ ZIP `TTS63 <br /> rYPFQFOWNE HEP <br /> ORPOPAYTON❑ IRDIsnDunt.❑ PARTNERSHI ❑ FEDAGENCr❑ Onnit❑ <br /> FACILITY FILE <br /> i <br /> t�..�'.f ""r � IA4 `�,.. � .. '., ai.s.:w. ...ACCO .,..� w:�.•w'i!-i��4��Sw f`.dila..4x'�`�;� ..�fY"� <br /> .FAatsTYb` <br /> :OMPLMTHEFOuoWING BUSINESS/ FACILITY I SITE INVEORMA77ON: <br /> T;this a NEW Business LOCATION not previously regulated by the ENVIRONMENTAL HFfA�y�N�'D/IVISIC (t'/� Vn/r y.n yes ❑ NO <br /> Is this an ExesniNG Business LOCArroN but a NEW TYPE of regulated Business 7 / 0 `[fl, (SVIU 'f ou (,(HCl. yes ❑ No <br /> BUSINESS/FA(=L=(/St1E NAME <br /> Srre AQPRP!S � • n a fM a'tN'\ / 2qq A _ _ !k S11Ere#. BU PHONE <br /> Qty , � 7JSV( 4 '`�[��jj��{ 4 �15�oa- <br /> . LDa7mN LADE .Keel �v2 <br /> BOARo,CPSUPERYSORD13TRiCr I :: �.... . ....I <br /> Mailing Address ifDZFFERENTRD/A FadWAddrP.sP I Aftnillon:or Care Of <br /> 30S No>�ctra �L eve �t Me. )(#'YW <br /> Mailing AddMSS City STATE�A zip .0 <br /> w <br /> 'J'-�. <br /> SIC Eo°e' L _ <br /> THIRD PARTY BILLING INFG; Complete if Billing Party is ddferent from Property Owner orFadliliy Operator/denhFed above. <br /> BUSINESS NAME eo� -P L_ G Attention-arcane Of CoP6'ona/) & P. <br /> Mailing Address 'Vyvjr/r��{ VVVEEE��, L PH°"E <br /> p0 <br /> CM sT__1'1 y�O!q SYAre(A ao f45Ao,�-- <br /> ACCpyprTAOQ=W for fees and charges OWNER FACILITY/BUSINESS THIRD PARTY BILLING <br /> Bn INC.AND COMPt AN F ACA OWLEOCMPNTt I,the undersigned Appileant,cerdfv that 1 am the Otanrr,Operaror,or Authorracd AEene of this Businmi,and I adulowleden that all PERMIT FELs, <br /> PEN.Qrids,ENroRCemENTC94RCCS and/or NOVRLTC)Lunxs assoeimed with ibis operationwill be billed in me at the address Identified above as the AtXVi/WADDAESA for this sito. i also certify thatall <br /> information provided on this application is true and mrr"t;nod that all reamated teuvities will be virfornsed in aeeonlanee with all applicable SM JDAou1N CousnY Ordinance Cala aim/or <br /> Standards and STATE and/Or PEDERU.Laws and ReEulaEWm. AS file undervfned owner,operamr,or agent of the property Imated at the above farlllty/Ole adi rcin,I lwmby..'horIS the release of <br /> any and all resuih and environmental assuslment Information m SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DIVISION as soon as it Is available and at tilt some time It is ProvidN W <br /> me or my ttpreventadve. <br /> I ,/ PLEASE PRINT <br /> APPLICANT NAME `�//TTY ,JA X � SIGNATURE <br /> it <br /> ICFNSr <br /> TITLE !' f�A1' PH�orOECOPrLREQUIREt1 . <br /> "k Fc[JNAMIG [�f �Fl��n : (i hl'� IAL <br /> ApDr°ved BY Damg ofce Piilcming.Campleted BY <br /> AQcountln,. ., , <br /> et-xaessz, <br /> I,D,Tfl nl <br />
The URL can be used to link to this page
Your browser does not support the video tag.