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avKe Refit Information _ T _.—�-- <br /> Facility ID• Billing Account ID: <br /> Re<I ID: 9=71517 1 Update address <br /> Facility Name:I' <br /> Site location:12440 5 AIRPORT WAY Site address: 2440 5 AIRPORT WAY <br /> Copy Address With: <br /> Entered date: 2/13/2015 _ Entered by: DSEDRA� Update date:O Update by: <br /> `loretlen ertl Owner IrtMmatlen � —� __ -.� <br /> Q,10me0roperty owner: <br /> Number: 2440 --�Direction:��Street name:AIRPORT Strout typo:WAV <br /> Unit type: Unit: APN:116913327 <br /> CRY:ISTOCUM State:�ZIP Cotla: 95206 <br /> Country; (none) I Location: STDCKTDN District code: VILLAPUDUA,CARLOS <br /> Phone 1: (209)9221475 Phone 2: (209)513-6552 <br /> , (rep Req.1st-4110114111IFilli <br /> Business name:IcAusoi CATERING SERWCE <br /> Requestor address:1430 N PAIR ALTO ST <br /> City: MOUNTAIN HOUSE State:� ----- ZIP ZIP Code: 95391 <br /> Requestor Phone: (209)9221475 <br /> --_— Nati SerAca <br /> Nature of service:IFOOD VEHICLE INSPECTION —_—� — <br /> P/E Code:11603 P/E Description: FOOD VEHICLE INSPECTION <br /> •leak Detector •Sesor •Spa&xket .Drop Tube •Cold Stat .Seoortdey Containment Other: <br /> Received by: FRANK GIRARDI Date: 2(13/2015 <br /> Assigned to: LISA MEDINA , Date: 2/13/2015 <br /> Plan type: (none) <br /> Amount paid: $130.001 Cheek number: ArchWad: (rune) J <br /> Due date: Requires MU 0 KW <br /> ---- — — — ---- <br /> Date request approved: Pian status: (sena) _ _ � LIC x 3595281 <br /> Date revision requested: Lost activity dela: <br /> Service memo: NEW VEHICLE <br /> Date revision submitted: <br /> Final Inspection: <br /> is <br /> l' Latitude: Plan ThkAddrKS on a Mao <br /> Longitude: <br /> Elevation: <br /> AM an Ef®t <br /> _.._— <br /> Contact person: ---_-------_— <br /> Addressl: <br /> Contact city:(-tone) State: ZIP Code: —� <br /> Country: (rwne) <br /> Contact phone:l Extension:I <br /> Submitted: <br /> Inspection code: (.tone) <br />