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11-03-2000 09:31AM FROM TO 19258339548 LT. .02 <br /> T ;.. . , .--•• ---•+_... ....... ��Y.�?:d!.t�pa.;;�clLvtr}Lf)J�*rlF£9�£3.E!rG�l)I131f?n.:.�.wa...«.w,.,. <br /> Mppµµ STER FILE RECORD INFORMATION '`MFR GREEN FORM <br /> 61tEREP aaE!s r4"EBQLEfStlLY Y�` yt � Yr <br /> Ip#i '�;,{ } '',�.",i',�xzs?' UNIT IV <br /> OWNER FILE DOQ <br /> :OMPL15 <br /> ETETMEFOLLOW/NGPROPERTY OWNER INFORMAT/ON: NEcr1F OWNER CErRRswnronriteWIrMEHD <br /> PROPERTY <br /> OWNERNAME Award Homes (925) 833-9297 <br /> M4 <br /> Us <br /> BVSINFSS NAME Ra MI <br /> Award Homes SOC SEC/TAX ID# <br /> Owner Home Address 404 Saratoga Avenue, Suite 100 DRIvER's LICENSEp <br /> city Santa Clara STATECA QIP 95050 <br /> Q.w Meeh#AddYaas <br /> Ste 100 <br /> Mailing Address City Santa ClarA State <br /> }[}( CA ZIP 95050 <br /> :ORPORAYION 60X' INDIVIDUAL0 PARTNERSHIP FE2 AGENCY OTHER <br /> eee3l FACILITY FILE �p �y� ryr�fn WWu�{yW <br /> t f}ACILnY ID#,41, ,',/jyt w `A i�it air xutNuj%IM. aV- 't "'TA t � ^ "r ,.,iA000UNi.w'Y#�Tcf�. INP �f:bWM•`..by1t 31M1ic"^,kly:±)lynlcA:; ,1 R <br /> . .- - CiiosslR ID# `� <br /> 'OMPLETETNEFOLLOW/NO BUSINESS/FACILITY/SITE /NFORMAT/oN. yy <br /> S thisja NEW Business LOCATION not preViwaly regulated by the ENVIRONMENYAL HEALTH DIVISION? YES V"t! NO 0 <br /> s UYls;an EatsnuG Business LOCATION but NEW TYPE of regulated Business? YES�❑ NO p <br /> 3USINEasrFACILITY/SITE NAME Award Homes <br /> ifTE ADDRESS ' SUITE# BUSINESS PHONE <br /> 4 venue, e <br /> (925) 833-9297 <br /> ITY $an+n r'9 ra <br /> STATCAE z1-q�0 SIJ <br /> �,�. »1 330 <br /> t4�9P_LiE k[EA1gE4�u t .1.1 rpt t$lR .{JSkY_9 ��' ___� tt a P R .�°`": afZW <br /> 10 <br /> Aniline Address//O/FFERENr from FaciBryAddress Attention: or Care Of(opoonaQ <br /> Aailing Address City STATE ZIP <br /> MCI; <br /> 'I[iCOOE. ' .9.vi {i v 't. I AYti::3.�y� �Viy7 vYa x 8� '2Ery'r:k: <br /> APN#7 . ,k� X: COMMENY":+Sr+LYINia' MIN <br /> '416t sa3lxio-+.f s_ <br /> HIRD PARTY BILLING INFO: Comp/ete if Billing Party /s different from Property Owner orFacility Operator identi/Iedabove. <br /> SUSINESSNAME Terrasearch, Inc. Attention: orCare Of (o Ibnn/11 <br /> Mr. Robert LQampbell 5''L 2.Y3( 66-L <br /> Mailing Address 11840 Dublin Blvd PHONE(92-5�� <br /> :1Y Dublin 11 <br /> STATE CA ZIP 94568 <br /> 9QCOUNLAQORE$3 for fees and Charges - OWNER FACILITY/BUSINESS THIRD PARTY BILLING <br /> - _ _. Ism uw�as�ninss�ls <br /> A.Mr,ANn Coatrl,uNs:r.ArwnowLY.ncnn:nr; 1,file undersigned Applicant,certify ninE i am the Owner,Operator,or,IalhorizrdAgrol of this Business,mad I acknowwge shut all <br /> PAI/r FRI_Y,PRNAIJIM.ENFI1aX[AreNT CIJARGC1'and/or HOURLY CIIAR G£T associated with this operation will be billed 10,119 al the address identified oboe as the AfY bUNTAInbkRTS <br /> this sPe. I also eirttry,Ihmt all int'ernndion provided on this application Is true and confect;and that all regniated activities will be perfnrmwl in acconlance with all applicable SAN <br /> tQVIN',.CQUNTY Onlinance Cedes and/or Standards and STATE and/or I'EsXnAI,i,aws and Ihgatntions. As the an4cnigned owner,operator,nr rat of tlwe property Mcaled ii tht <br /> we fatility/site address, I bereby aWhorizv the mlease or any and all results and cnvirmmupltal assessment h1torma;(to SAN JOA I COUNTY ENVIRONMEN1 At. <br /> :AI,TI11 DIVISION As anon ns it is available andat Ehe same lime it u provided In tut or my rcprexenalivc. <br /> PLEASE PRINT <br /> ,PPLIbANT NAME Robert D. Campbell SIGNAT <br /> ITLE Manager, Environmental DRIVER'S LICENSES <br /> -IeMOTO.nw nroul eM <br /> .. .tae .,..:..'. ,.� -n:a Y t.+ el, rr ♦ Nt <br /> iPp�rOl+ed CY ,i, <br /> I <br />