Laserfiche WebLink
11/21/02 THU 15:29 FAX 1 919 881 0430 SECOR-SACRAMENTO 11002 <br /> 11/23/2002 13:76 2094 33 FIFTH FLOORAl <br /> PAGE 92 <br /> rl ''rV:ya Irrce" IE4 R . 11611�1�1 It I" <br /> w <br /> d <br /> MASTER FILE RECORD INFORMAmm 'AMFRrr GREEN FORM <br /> Jr ...- iWO UNIT IV <br /> OWNER PILE <br /> COMA wrArcP DPERTYO NERI noAr• f7lrrxJrONINER L7JCRasaTLrtavra'eNdnyE}Io <br /> pur�etTaalrtae C'j / a' •j' j pei�E <br /> 17);` <br /> W � <br /> ENSaass NartE <br /> 9oGSct!'1»1D7 4 <br /> Owner Nome Address GIdUIM N e <br /> a sun 77P <br /> one,waaa Am <br /> Mailing Address ally Sbft /'7 ZIP �y <br /> r.wona..rna Cl >r,ae.nuup amataprnp[] (J n /J <br /> Is Zhao New flu®ness LoDumw not plevinudy regulated by aE EevmolMpr}Atmm,,t IlEpARr"77 Y64 ❑ No <br /> u dus sn EdmmG ausinew L=Tion but a Mmrm of regulated audit/ 7 YES ❑ No <br /> Sart Aooaers / /'�/L/V��VY<//•`I J �v &+cif bu�Peaeu <br /> CM ST 71P <br /> rIwS <br /> Malting Addrees iYDZ9WtGYrrronr fauNyAdkb. Atow tion:ar Cam M <br /> Milling Address City STATE 2v <br /> �" �� rte-•-- 9 <br /> 'MIRO PARTY BILLING INFO. Com#efelf Billing Party isdlAErt'rltfran Property Owner or Fadky Operator ride ,edabove, <br /> l um Nw Avennon:ororeof CobwO <br /> Railing Addr m'Salz /W ERe1E Aoll (/KP <br /> STAN MP <br /> Cj- <br /> &MAWRE0 forfees and charges OWNER FAcurylaustliHss •WIRD PARTY ENLLM <br /> r mf-r.v rmtry�_eres Araanavr vtruvar• C�oedeedQned AMdioant.wrdfy mt 1 am ebr l7.aarr QpnaaM1•ar Aadumyd�Qmu of Mir Mari and 1 <br /> " rvar, arkawed6a lbae W,lTarmr FRrl. <br /> sv.+u+as,LvroselMlm pue(ss.ed/ar$e�yGUnG6S avaeiaml wdh fh' operation wll os binnl to nm ar We Adnm IdegdNod Whore as rkA=eMXA=Mfar ddl 8w X aka mrfily rya[an <br /> fwx..wa pr*VAW ae dk appllearien a Iroe and CW—M and cW t aN re III=Mdry-111 be perfarmed in umdaeeC wbh dl applhrbin SIX JnAQON Cotntvv OrdVaxr Codm an&w <br /> aodvrds W STAT[. or PenewL Law$and Regvlau As the unde } awver.yvnmr.ar lgem ids preperp-leeamd x the.bore fadllgLie addres,I aereby arsmoAae rLe reieyc N <br /> q and all Taenia and enyromaaml a.eermeoe inforaudoo ra SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT ae ocn a9 it it avaWble and at[be same a ne it a <br /> wined m me or nw rcpnn nudve �/ S .// �/ C��j�fj//7 <br /> APPLICANT NAME�Gr,(// kt /!/riVF-�� Smuri <br />