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Pqu1N <br /> San Joaquin County <br /> y: < <br /> Environmental Health Department <br /> 304 E Weber Avenue FAX #: 9 (209) 464-0138 <br /> 3rd Floor, Stockton, CA 95202 O (209) 468-8392 <br /> Phone: (209) 468-3420 O (209) 468-3433 <br /> FAXDate: 3/24/05 Time: 4:25 pm <br /> # of Pages (including this sheet): iC <br /> To: Park Ozuk FAX #: ( 530) 272-1115 <br /> Of: <br /> From: Violet Davis Voice Phone #: (209) 953-7895 <br /> Re: Form 5021 — New Owner of Best Cleaners <br /> O Urgent O For Review O Please Reply O Please Recycle <br /> Comments: <br /> Please complete the right side of the form, including owner's social security <br /> number. Also, we need a copy of the owner's driver's license and a $20 check to cover <br /> transfer fees. Send to the above address. Please call the number above if you have any <br /> questions. <br /> STATEMENTOF CONFIDENTIALITY: The information in this facsimile is legally privileged and confidential information intended only for the use of the addressee <br /> listed on this cover sheet. If the reader of this message is not the intended recipient,or the employee or agent responsible to deliver it to the intended redpient,you <br /> are hereby notified that any dissemination,distribution or copying of this telecopy is strictly prohibited. If you have received this facsimile in error,please immediately <br /> notify us by telephone at the number listed on this cover sheet and return the original message to us at the above address via United States Postal Service. We will <br /> reimburse your costs in notifying us and returning the message to us. Thank You. <br /> EHD 48-01-012 FAX COVER SHEET <br /> REVISED 5-13-02 <br />