Laserfiche WebLink
Type of Business or Property CI-1,1. FA - r_T /TV In <br />SR 66779S Fo 0 ct rcitcl<_ I <br />C:. <br />FAcury NAME <br />STATE <br />Exr. I ADM 4{ <br />II BOS DISTRICT II LOCATION CODE <br /> - <br />COINTRACI 01( / SERV <br />PHONE #2 <br />HOME or MAILING ADDRESS (If ^iffe.rerit. from Site Address) <br />ea -Fax ok--y 1SS <br />CITY E \• <br />(c7) <br />S9- ç-(- • 4-1-2- 52-• 7 COS <br />6142fNtumber Direction I ReValleft. I rc":: C?-ffel)le <br />EXT. <br />ZIP ci s 7 5_ .e <br />, wun. <br />7rFn"7-.ST.OR <br />Qe, ( 0\rt5. <br />firm= nr RBA II non Arls-,D=ec <br />FoK LuCIA_)- <br />Crrr <br />(C CO ve <br />J <br />C.HECK ii Bit LING AnDRFss ci <br />FAY a <br />" 025--5 .075 <br />L... <br />VTAT <br />qc5 7ST I <br />.. • <br />/ ( 7 <br /> <br />Fur,' '""-r-4. <br />—7 C-1- <br />1 -7 <br />- <br />-&1/11 <br /> <br />SAN JOAQUIT 'OUNTY ENVIRONMENTAL HEALTH "' ';ARTTviENT <br />SERVICE REQUEST <br />11..1,1";AOTK.I.r..A I 161•11 I() ••• • ••-•I••. vv •It-11 eit-. ••••4•i• •••••• • ...:•'•••• <br />PAYMENT <br />EEd rZEcenfED \i eh rde_ i/7`2/.3-ec--7L7(->') <br />JUL 2 1 2017 <br />SAN JOAQUIN COU <br />NTALNTY ENVIRONME <br />HEALTH DEPARTMENT <br />P, <br />L k- 7cce7 <br />Acn-tpo-rrn Pty. <br />S;P C.k (CI <br />-• u\)c--.J1c) <br /> 6u.A <br />6r7ti 4 0 0 411-i