Laserfiche WebLink
San Joaquin County Environmental Health Department <br /> DATE 08 _ MASTER FILE RECORD INFORMATto_N "MFR" GREEN FORM <br /> .a.cun,..rwvv ONNERID# /0 UNIT IV <br /> _ ! l.E OWNER FILE <br /> Commm rmzFoLLowrm PROPERTY OWN ER ZW-ORMATION• morn OWNER CV xemnYmmuwrnr END ❑ <br /> Paoeanrowm amm PM <br /> FirstI JH I Lest <br /> Bums Nus Ment swnqs o s fix. smsm/-rutD# <br /> owner xaR.Aeerua 500,5 LBS Fret Stu 2 50 DweR's Llcueus <br /> My PaflcL5 sTA7 TX z1P 7.s 1�r <br /> O.r Melling Add.. <br /> MaIIIng Addres CRy ;;,o zlp <br /> Caolo.ATrortw (/ [rotvmuR.❑ PAoxeraxN❑ no AU 1:1 Or"IN <br /> FACILITY FILE <br /> � FAOLm ID# I i?VVO — CROs REFTD# AccouaTAp� ray#�( <br /> Is INS a NMBUSh* s LOunoN not pfevkHrAy regulated by the ENWRoamErrAt HEALTH <br /> D�EPARTMEIM Yu ❑ No p <br /> Is this an E)usTwc Buslaess LOCATJOn but a NEW TYPE of regulated <br /> cBusiness? vEa ❑ No <br /> Bunaes/FADUJSMNue F 6�0 FALI <br /> SITEADDREStsuns# Busraeuprme <br /> D W. Crlp( 1 Q.r W <br /> cm sfockfoA STM CA LF 9Szo6 <br /> BoARooESUEetyLroa DrselarrLorAhxOa co- IGYI KEY2 <br /> Mailing Addy RD1ffFRFMTdsn Fadbtyolddi AttentlM:or Gars of(OPOO /) <br /> Malting Address City STM LF <br /> SIC Co F APH# COMMEM <br /> THIRD PARTY BILLING 1NPOp CVF!/Atete if Billing Party is dMerent from Property Owner or Facility Operator/dello va'above. <br /> 1Al MNAW Attentialc drCreOf(dPOj <br /> Malting Addm Pa <br /> LTrr %ATF zw <br /> Alf mdaaaw for fees and charges FAcam/BUSINEss THIRD PARTY BILLHG <br /> Rllllnf.ANnrOrn1ANry ACN Wlr,N'MrNT; ;Ihe un ay lhsllmLLe Pvner,l9PeMer,orAW4ariudAgmr al dN Bolnra,uMlrsYarwledretW Jl PFlenrfszs, <br /> PanArmFs,Fi+Foa[lAebvrCw.lefiy rrNor DOUAtYCNAAGEJ rsswhted wNh Ma aprrMba wE be billed Ir mr rt the addms IdmMed Abrve n Ihr 6�.dBPdl6f for the site.[rho crrtxy tWl <br /> r6 b6rnufbn provNN on I W rppaearlao a tree ud corrmA nd Ibt LL rcLnbkd re1lvUb will be grforued ti rerarduee wilb ea opp' u JOAQVIN CoIMY Ordharn Codes Ard/m <br /> SlaadrrdraWSTAManNerPlaMLLAWsood RMp ti s.Astheuwdw3kkdowmr,rprrMsr,orepnfoflheprtpero brMed rl the eAelltlyhar rddms,ihv YroJwkc the rtlerwN <br /> Try unci al mulls nd oviromaeolrl ones m fafardIbr M SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH T IFTrr n rooa,/511 a aw6N and er Ne nm Iine U U <br /> provHed to weer oy rcpmenrvlive. , <br /> APPLICANTMAME : t.7r+1' /-tc�a <. sIGxA E t-�k <br /> TITLE I DaIYE sLI aces <br /> Vj'I�Fj V7 kyj e713 4L <br /> (PROMCfIly umro <br /> Appro BY W[a 1 D Amnund"Was P+owame ComVl BY Datd <br /> 29.02002 ApeRS'..:olt <br />