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e i <br /> 1 � <br /> OAQuf� � c <br /> San Joaquin • �. oG <br /> Environmental Health Department <br /> 304 E WeberAv�nue FAX #: 9 (209) 464-0138 <br /> 3rd Floor, Stocktc}n, CA 95202 O (209) 468-8392 <br /> Phone: (209) 468-34� 0 O (209) 468-3433 <br /> FAX Date: 4/5/06 Time: 2:45 pm <br /> # of Pages (including this sheet): <br /> To: Kenneth Crawford FAX #: ( 209 ) 839-0051 <br /> Of: Back Roads Custom Cycle <br /> From: Norva G ese Voice Phone #: (209) 468-0340 <br /> Re: 5 21 Form attached <br /> O Urgent O For Review O Please Reply O Please Recycle <br /> Comments: <br /> Thank you for your recent payment of the invoice that I faxed to you. <br /> Due to th, fact you are the new owner, we need you to please input either <br /> your SS# or tax ID # if you are a corporation, sign and date the form that I am faxing <br /> to you and send a copy of your drivers license for our files. Upon receipt of the <br /> above information we will change the owner info in our files. <br /> Thank yin advance for your prompt attention to this matter. <br /> If you hare any questions, please feel free to phone me at the above number. <br /> STATEMENT OF CONFIDENTIALITY: The information in this facsimile is legally privileged and confidential information intended only for the use of the addressee <br /> listed on this cover sheet. If the reader f this message is not the intended recipient,or the employee or agent responsible to deliver it to the intended recipient,you <br /> are hereby notified that any disseminati n,distribution or copying of this telecopy is strictly prohibited. If you have received this facsimile in error,please immediately <br /> notify us by telephone at the number lis ed on this cover sheet and return the original message to us at the above address via United States Postal Service. We will <br /> reimburse your costs in notifying us anireturning the message to us. Thank You. <br /> EHD 48-01-012 FAX COVER SHEET <br /> REVISED 5-13-02 <br />