Laserfiche WebLink
Daterun 2/7/2022 2:11:23PM SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br />Run by Paget <br />Facility Information as of 2/7/2022 <br />Record Selection Criteria: Facility ID FA0012769 <br />BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site, anclior project specific, PHS/EHD hourly charges associated with this facility <br />or activity will be billed to the party identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinance Codes anctor Standards and State ancilor <br />Federal Laws. <br />APPLICANT'S SIGNATURE: <br />Program Records to be TRANSFERED: <br />Water System to be TRANSFERED: <br />Payment Type Check Number <br />EHD Staff: <br />COMMENTS: <br />$25.00 = <br />Date <br />Date <br />Amount Paid Date <br />Amount Paid Date <br />Received by <br />Account out: Date <br />Invoice #: <br />