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SR0083445 (3)
EnvironmentalHealth
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2900 - Site Mitigation Program
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SR0083445 (3)
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Entry Properties
Last modified
10/28/2022 4:25:48 PM
Creation date
10/28/2022 4:10:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
BILLING
RECORD_ID
SR0083445
PE
2903
FACILITY_ID
FA0026288
FACILITY_NAME
VENETIAN SQUARE
STREET_NUMBER
4555
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11017001
ENTERED_DATE
3/23/2021 12:00:00 AM
SITE_LOCATION
4555 N PERSHING AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\tsok
Tags
EHD - Public
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°c SAN JOAQUIN <br />CC)U NTY <br />ogc��o Greatness grows <br />Receipt <br />Payment Date <br />Confirmation Number <br />Payment Method <br />Expiration <br />Approval Code <br />AVS Response <br />Bill To <br />San Joaquin County Environmental <br />Health <br />1868 E. Hazelton Ave. <br />Stockton CA 95205 <br />(209)-468-3420 <br />03/11/202104:32 PM PST Payment Status <br />121959172 <br />Credit Card (VISA) ************1863 <br />##/## Transaction Type <br />08598D <br />Y CW2 Response <br />Clayton Blackburn <br />1372 Creekside Drive Apartment 11, Walnut Creek, CA - 94596 US <br />Payment Towards <br />Payment Towards <br />Site Address <br />Phone Number <br />Payment Towards <br />Site Address <br />Phone Number <br />Payment Towards <br />Site Address <br />Phone Number <br />Charge Information <br />Service Request Or Well <br />Permit <br />4555 N Pershing Ave <br />9252315366 <br />Service Request Or Well <br />Permit <br />4555 N Pershing Ave <br />9252315366 <br />Service Request Or Well <br />Permit <br />4555 N Pershing Ave <br />9252315366 <br />Amount <br />Business Name <br />Amount <br />Business Name <br />AUTHORIZED <br />Purchase <br />IL <br />$912.00 <br />SLR International <br />$456.00 <br />SLR International <br />Amount $608.00 <br />Business Name SLR International <br />Agency Amount <br />LexisNexis Service Fee <br />Total Amount <br />$1,976.00 <br />$45.25 <br />$2,021.25 <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 />®° <br />LexisNexis- <br />RISK SOLUTIONS <br />Home I Payment Solutions I Contact Us I Terms and Conditions Privacy Policy <br />TRUSTe <br />�_.s'L'_J �_.. .__.. <br />
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