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PUBLIC ALTH SERVtES <br /> PQUfiy <br /> SAN JOAQUIN COUNTY S'°• G <br /> ENVIRONMENTAL HEALTH DIVISION r. <br /> Q• r\ <br /> Ernest M. Fujimoto, M. D., M.P.H., Acting Health Officer 'S <br /> 304 E. Weber Ave., Third Floor • P. O. Box 388 • Stockton, CA 95201-0388 <br /> 209/468-3420 <br /> e+��f91� <br /> oc rrs F40(-M044 <br /> rw DO �Z,- V(/(f/ <br /> In compliance with STATE and LOCAL contractor licensing and worker's <br /> compensation laws, we are requesting that you provide copies of the following: <br /> A) CONTRACTOR POCKET LICENSE (Showing Expiration Date). <br /> B) WORKER'S COMPENSATION POLICY (Showing Expiration Date). <br /> (If you are OWNER/OPERATOR ONLY and have No EMPLOYEES, please <br /> complete the enclosed waiver and return). <br /> C) CALIFORNIA LICENSED CONTRACTOR QUESTIONNAIRE (Enclosed). <br /> PERMITS WILL NOT BE ISSUED until we receive this information. If you should have <br /> any questions, please call Sylvia at (209) 468-3456. We appreciate your prompt <br /> attention to this request. <br /> Donna Heran, REHS, Director <br /> Environmental Health Division <br /> Enclosures (1 ) <br /> /SS��o� <br /> 001 CF � 7 � / q Division of San Joaquin County Health Care Services <br /> FP,Y �b 9 - 3V33 <br />