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SR0083415_SSNL ADDENDUM
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SR0083415_SSNL ADDENDUM
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Last modified
2/24/2022 1:21:10 PM
Creation date
2/23/2022 5:06:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL ADDENDUM
RECORD_ID
SR0083415
PE
2602
FACILITY_NAME
88 MARKET & GRILL
STREET_NUMBER
21850
Direction
E
STREET_NAME
LIBERTY
STREET_TYPE
RD
City
CLEMENTS
Zip
95227
APN
02120024
ENTERED_DATE
3/16/2021 12:00:00 AM
SITE_LOCATION
21850 E LIBERTY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Tags
EHD - Public
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R���nLDlx; 3 <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH <br /> 1868 E HAZELTO AVE STOCKTON CA 95205-6232 <br /> Phone: 209-468-3420 <br /> WATER QUALITY EMERGENCY NOTIFICATION PLAN <br /> Please make sure the writing is as clear as possible. <br /> WATER SYSTEM INFORMATION <br /> System Name 88 Market <br /> Physical Address 21850 E Liberty Road <br /> City Clements State Ca Zip 95227 <br /> PROPERTY OWNER INFORMATION <br /> Name Steve Khanshsli <br /> Mailing Address 10,000 Crows Landing Road <br /> City Crows Landing State Ca Zip 95313 <br /> Phone 209-605-2370 Fax <br /> Email Ooasis3@gmail.com <br /> OPERATOR INFORMATION <br /> Name Sam Hedge Title Water Distribution Operator <br /> Mailing Address 30,000 Kasson Rd Unit 290 <br /> City Tracy State Ca Zip 95304 <br /> Phone 209-406-6069 Fax <br /> Email samhedae(cDcaldsl.net <br /> The following person is being designated as the responsible party for responding to administrative and other <br /> nonemergency correspondences: <br /> ADMINISTRATOR INFORMATION <br /> Name Steve Khanshsli <br /> Mailing Address 10,000 Crows Landing Road <br /> City Crows Landing State Ca Zip 95313 <br /> Phone 209-605-2370 Fax <br /> Email Ooasis3@gmaii.com <br /> The following person is being designated as the responsible party for responding to billing and invoices: <br /> BILLING INFORMATION <br /> Name Same as Administrator Information <br /> Mailing Address <br /> City State Ca Zip <br /> Phone Fax <br /> Email <br /> /Users/samhedge/Desktop/88 Market WOENP 03-18-2020.docx Page 1 of 2 <br />
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