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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E.Hazelton Ave•Stockton,CA 95205-6232•Phone(209)468-3420 <br /> Jasjit Kang,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> ANNUAL OPERATING FEE PAID-PE 4634 -TRANSIENT-NONCOMMUNITY PUBLIC WATER SYSTEM <br /> Permit ID# PT0026774 for Record ID# PR0543287 <br /> Valid From 7/1/2022 To 6/30/2023 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: SIBLEY, NANCY <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: OLD RIVER GOLF COURSE Facility ID FA0015823 <br /> 18007 S MACARTHUR DR Account ID AR0027489 <br /> TRACY CA 95378 Issued 5/19/2022 <br /> Billing Address: ATTN : SIBLEY, NANCY <br /> OLD RIVER GOLF COURSE <br /> 461 UNIVERSITY AVE <br /> LOS GATOS CA 95032--441 <br /> 7027.rpt End of Report <br />