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SR0084975 (4)
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2900 - Site Mitigation Program
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SR0084975 (4)
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Last modified
10/26/2022 2:08:55 PM
Creation date
10/26/2022 2:04:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
BILLING
RECORD_ID
SR0084975
PE
2903
FACILITY_ID
FA0027045
FACILITY_NAME
1992 NORTH DELTA SEEPAGE MONITORING
STREET_NUMBER
20250
Direction
N
STREET_NAME
STATEN ISLAND
STREET_TYPE
RD
City
THORNTON
Zip
95686
APN
06902019
ENTERED_DATE
3/9/2022 12:00:00 AM
SITE_LOCATION
20250 N STATEN ISLAND RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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viuui�. 1 u�'iu�,ut� - i.t.ni�i�t.�t� i ayuiti.ut vviutivt.� I"c1.�,G 1 Ul. G <br /> I© San Joaquin County Environmental Health <br /> 1868 E. Hazelton Ave. <br /> Stockton CA 95205 <br /> (209) 468-3420 <br /> Receipt <br /> Payment Date 02/25/2022 08:59 AM PST Payment Status AUTHORIZED <br /> Confirmation Number 139498027 <br /> Payment Method Credit Card (AMEX) ************1075 <br /> Expiration ##/## Transaction Type Purchase <br /> Approval Code 224922 <br /> AVS Response Y CVV2 Response M <br /> Bill To <br /> tyler harrison <br /> p.o. box 42 , Gait, CA - 95632 US <br /> Payment Towards <br /> Payment Towards Service Request Or Well Amount $456.00 <br /> Permit <br /> Site Address N. Staten Island Rd Business Name Valley Drilling <br /> Phone Number 2093692779 <br /> Ch rrje Information <br /> Agency Arnount <br /> LexisNexis Service Fee $10,44 <br /> Total Amount $466.44 <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 /> LexisNexis <br /> Home Payment Solutions Contact Us Terms and Conditions Privacy Policy <br /> Im0 FC- TRUSTe <br /> https://payments.lexisnexis.cola/billinglnfoConf.xhtml 2/25/2022 <br />
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