Laserfiche WebLink
May 22 03 02: 18p cr le Farms 2n ,i67 1615 p. 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> op°'v I N•..c <br /> SAN JOAQUIN COUNTY.Donna K.Heran,RE.H.S. Unit Supervisors <br /> Director 304 East Weber Avenue,Third Floor Carl Borgman,R-E_H.S. <br /> Al Olsen,R.E.H.S. Stockton California 95202-2708 Mike Huggins,R.E.H.S.,R.D.I. <br /> �4CiF0'{i��P Program,blanager �'elephone (209)46$ 3420 Diauglas W.Wilson,R.E.H.S. <br /> Laurie A.Cotulla,RE.H.S. - - <br /> gamt Lagurio,RE.H.S. <br /> Program Manager Fax: (209)464-0138 Robert McClellon,R.E.H.S. <br /> Mark Barcellos,R.E.H.S. <br /> CERTIFICATE OF NON -OPEPMTION <br /> NOTICE: Health and Safety Code Section 17037.5 requirDs any per:on ceasing <br /> to operate or maintain employee housing to annually file .a <br /> Certification of Non-Operation with the enforcement agency for two <br /> (2) years following the d`scontinuation. Section 17037.5 is reprinted <br /> on the reverse side of this page. For additional Information call the <br /> Department at (916) 445-9471. <br /> Certificate for Calendar Year 2003 Employee' Housing Facility I.D. No.;,9- fl 0 Obi <br /> Employee Housing Facility Name_Sara 1 e F, <br /> Address 1 Clifton Ct . Rd. Stockton <br /> Operator Name&Address Saraie Farms fir.r,r_tr��n� rn 95206 <br /> Telephone Number <br /> Property Owner Name&Address Main Stone Cor ora g?�fhl _aoalt -, Merced <br /> Reason for Discontinued Operation (Check as appropriate) CA 95 340 <br /> Property Sold To: or: <br /> Housing Deslrayed(Date): <br /> Housing Facility still exists, but will not to occupied by any employees any prrt of the year. <br /> Facility will only be occupied by_(less than 5),employees during the calwndar year. <br /> Other, or explanations: <br /> i <br /> Maximum number of employees who have or wia occupy the facility identified above during the calendar <br /> year <br /> Certification: I,_ Thomas . S&ra 1�r_ .as rFn <br /> (Print Name) (Title) <br /> certify under penalty of that the information provided herein is true and correct to the best <br /> of m knowled <br /> Signature Date .iz r <br /> HE AND SAFE`1•Y CODE SECTION '17037.a� �0ICENEF <br /> MAY 2 2 2003 <br /> Lcaoos <br /> ENVIRONMENT HEALTH <br /> ,�r•:F:'r���hVIL�J <br />