Laserfiche WebLink
San Joaquin County Environmental Health Department <br /> OATSGREEN FORM <br /> MASTER FILE RECORD INFORMATION "MFR" <br /> SHAMARMMaWomorttr OmmIDD OAaee UNIT IV <br /> OWNER FILE <br /> Co,wLkw7 fero,ucm,vGPROPERIYOWNER 1WRYA77om, OHMKV OWNER Cae�Yo N• %MEND <br /> Paopa Oe IlAw 'SuL <br /> > Pre Rt,, <br /> j Sx&oITMtIIDR <br /> 1t6,41 <br /> Pod MLad <br /> LLC— <br /> D~HaeAddreas <br /> Dsmesuas,,see <br /> DY BrAR `4 7JP <br /> timer YelMa AddreID 1�'�1 � i y I�L \ _ � q <br /> Me1Nq Address City 'l g�y�i-..,1� l 5a <br /> COAPowATax � INwwouu❑/� PAnr46uNM� Fm1larNor❑ on+ea❑ <br /> FACILITY FILE <br /> •Y <br /> ConrpLETETN6FmLowAFo BUSINESS I FACILITY/SITE IMFORAmnon.• <br /> Is this a NEW Business LOCATIDN notpreWousty regulated by the ErMRONMENTAL HEALTH Dir.? Y®13 No <br /> ISMen EWnNO Business LOCATION but a NEWTYPE of regulated Business? Ya El No <br /> 8usU1Pa5.PAdrm/SnE NAYS 1 L✓1 17f� .2 l.ti li -°�f S✓1^Cal L-ss P�,,� <br /> t <br /> t <br /> arreAoouss Z ��J e�=rn, ' t�� ��%� 1`l$O I V.� F \rT ume �,8udwrssPxoNa <br /> Ctiry a 00"l le. A . STAT C zip <br /> BOARD .� 'aUisrnmT LWATONCoaE Kerf KeYd <br /> MaIINp Add IPfERENTbemfanFlyAdd�st Attention:Dr Can Of(a Bold <br /> Melling Addreu CFly' STAT@ 7JP <br /> c I. <br /> sIcCoaE APNe <br /> THIRD PARTY BILLINGIKFa1 Complete dBlilingParty Isdifferent from Property Owner orFacilityOperator ldeaf ledabove. <br /> ausaimli Ye iuniv` Attadlon:orCary Of((gpffaW #Uk�f <br /> "'Ts <br /> 101'1Lp PLANS <br /> Cm I Lr�i 6_S BfA1[�� 7r `I J6in�r 6. <br /> 0 Tor Tess and C4erees OWNER FACII Tyffiusimus THIRDPARTYBLUNG <br /> tm...,:umr san¢Aadowtmevr,m f•drc mderslipd Apptim4nrdfy madam Poe O�mo�Opomor�or AutherfrdApW Df tleh&sely-s.nvdfadmwldle bat aO PrAAerpUi A, <br /> ptHHecrms,EHroA¢MTTOPAdo m&*rffomrG'81R sacdad with Poo ependmwR bcbMW w amatdmddrnn 1dw"edaboeeume,4CMw+/Atwxrt4 for dd,dee I ho«r*dna <br /> sE lorormadoe p nvWni m dh appamdoe Is true and mrrm4 and dut a0 rgnlonl aemid-nal ha pef rind Is roceNantt LAM 0 aPpdeable SMJOAQCN Gornto'Ordbeoa Cod-wVor <br /> Etadardsavd 6Tntt md/orFmeRLL laws and Rgnladom As ebe mdrrd�rd miner.epmror.orgmt ertlu propargbntrd at theabotsfrd4y/v¢eddr-a,Ihvebrwtbor¢a mr rdute of " <br /> aay and PR rmdit and m.imnmmed...I Inforwuoe m SAN JOAQUIN COUNTY ENVIRONMENTAL IMkLTH DEP "UNT u wen u ba awd at int oma dine h 4 <br /> pwNtd bmprcuabdra �� rj / /�// <br /> APPLICANTNAME Y6/4•M lL �-/1.1�i.g�y ftE.uePluxr BIGNANREi l+•,V//\ (/A`-["`t:"7/c�C.� <br /> IT" y p q DRNER'9 LICENSEe �^ /* <br /> , <br /> Approved ay DNn Acmten' OlRce prone-Np Cam sled 0a4 9 D <br /> 3901 I0/12J97 MASTER Fn.e Recop'"REEN <br />