Laserfiche WebLink
□ New Facility Dx Existing Facility <br />San Joaquin County Environmental Health Department <br />Application Form <br />Facility Name Relish <br />ZIP 95320City Escalon State CASite Address 1754 Main St <br />Supervisor DistrictAPN <br />□ Other□ Repairs or Remodel□ Consultation x Change of Owner <br />Comments <br />VINLicense Plate Number <br />Q Architect□ Contractor□ Property Owner.□ Facility Contact□ Facility OwnerR-Billing Party <br />□ Architect□ Contractor□ Property Owner□ Facility Contact□ x Facility Owner□ Billing Party <br />If contractor, indicate type and license numberLast name pompaFirst Name karen <br />ZIP 95355State CACity modestoAddress 3428 bear river ct <br />PhonePhone 323-530-7064 <br />□ Architect□ Contractor□ Property Owner□ Facility Contact□ Facility Owner□ Billing Party <br />If contractor, indicate type and license numberLast nameFirst Name <br />ZIPStateCityAddress <br />EmailPhonePhone <br />□ Architect□ Contractor□ Property Owner□ Facility Contact□ Facility Owner□ Billing Party <br />Type of Service <br />Requested <br />If mobile food <br />truck or pumper <br />truck <br />□ Application for <br />Operating Permit <br />Email <br />kjfpompa@gmail.com <br />Contact Types <br />required