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SR0084780 (2)
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2900 - Site Mitigation Program
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SR0084780 (2)
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Entry Properties
Last modified
10/12/2022 11:19:15 AM
Creation date
10/12/2022 11:17:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
BILLING
RECORD_ID
SR0084780
PE
2903
FACILITY_ID
FA0024100
FACILITY_NAME
FORMER SHELL SERVICE STATION
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95202
APN
12302012
ENTERED_DATE
1/27/2022 12:00:00 AM
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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San Joaquin County Environmental Health <br /> Our <br /> JAN J O A Q U I N 1868 E. Hazelton Ave. <br /> Q' Stockton CA 95205 <br /> "`!I•e- C O U N T Y (209) 468-3420 <br /> cgri=oaa�P Greatness grows mere. <br /> Receipt <br /> Payment Date 01/26/2022 06:55 PM PST Payment Status AUTHORIZED <br /> Confirmation Number 137967522 <br /> Payment Method Credit Card (VISA) ************1390 <br /> Expiration ##/## Transaction Type Purchase <br /> Approval Code 54545G <br /> AVS Response Y CW2 Response M <br /> Bill To <br /> Miriam Urena <br /> 8281 Commonwealth Ave , BUENA PARK, CA, CA-90621 US <br /> Payment Towards <br /> Payment Towards Service Request Or Well Amount $684.00 <br /> Permit <br /> Site Address 2575 Country Club Boulevard,Business Name Wayne Perry Inc <br /> Stockton, CA <br /> lPhone Number 7148260352 <br /> Charge Information <br /> Agency Amount $684.00 <br /> LexisNexis Service Fee $15.66 <br /> Total Amount $699.66 <br /> � Print <br /> Your payment was made through paymentsolutions.lexisnexis.com, one of the LexisNexis VitalChek Network Inc. portals. <br /> For business or technical support, please send an email to paymentsolutions@lexisnexis.com. <br /> For San Joaquin County Environmental Health support, please call (209) 468-3420 <br /> 0 LexisNexis- <br /> RISK SOLUTIONS <br /> Home I Payment Solutions I Contact Us I Terms and Conditions Privacy Policy <br /> [me PRIVACY FEEDBACK <br /> Copyright @ 2022 LexisNexis Risk Solutions.All rights reserved. <br /> (Page Last Update 01/26/2022 08:55 PM CST) <br /> 25:1051.102985:9.0.39.01.8.0.312 <br />
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