Laserfiche WebLink
Page 1 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES - ENVIRONMENTALHEALTH DIVISION <br /> MASTERFILE RECORD INFORMATION FORM <br /> NEW FACILITY CHANGE OF OWNER DATE OF OWNER CHANGE / /__ INACTIVE <br /> UNDER CONSTRUCTION CHANGE OF BILLING PR10R OWNER DELETE <br /> OWNER FILE <br /> OWNER ID �(� T"� CASE # BILLING PARTY Y / N <br /> OWNER NAME �G'CL KrIle U11C / ' (i1 L, <br /> i <br /> OWNER D84 Lo <br /> ADDRESS }I',�'I,�(� {/ ( Oyr P /J,r/i <br /> CITY IA/ i / + I ' I ✓<S STATE /1/ y ZIP /04�,05/-3S.ro5 <br /> OWNER HOME PHONE ( ) OWNER WORK/BUSINESS PHONE ( J?/Y ) / i 4/- <br /> MAILING ADDRESS �fV ( f- T' �Q <br /> CARE OF _ <br /> CITY �LY\ 1 �. {� /�1 nS STATE /V Y ZIP /�%�7r��{ • 3��5 <br /> BUSINESS CODE NATURE OF OWNER BUSINESS "'—'Y— <br /> FACILITY FILE <br /> FACILITY ID # ///1 3Zj j� BILLING PARTY Y '/ N <br /> FACILITY NAME Kea rrLe_v —1 PEE / # OF EMPLOYEES <br /> FACILITY ADDRESS 6 2– 7 G 1,117- TRUST LANDS? Y <br /> CROSS STREET El <br /> CITYC–_ 111 V\ STATE ZIP / ZV <br /> HOME PHONE ( ) - BUSINESS PHONE <br /> Eensus --------- BOS Dist Location Code c: City/ Code ---------- <br /> FACILITY or LING <br /> MAILING ADDRESS <br /> ,^0 v � �C <br /> CARE OF <br /> CITY C. �1 j-1 STATE ZIP <br /> APN # 74–Q SIC CODE <br /> UST FAC STATUS CODE BUSINESS CODE J BUSINESS TYPE (UST) <br /> GENERAL TYPE of BUSINESS at this FACILITY <br /> EH 01 15 (OWNFAC) revised 5/12/93 <br />