Laserfiche WebLink
SAN JOAQUIN G�y PIBLIC'HEALTH SERVICES - ENVIRONMENTAL HEALTH DIVISION <br /> i <br /> MASTERFILE RECORD INFOR14ATION FORM EH 01 15 CCiIi1FAC) Revis 5/14/93 <br /> ---------------- <br /> NEW FACILITY CHANGE OF OWNER DATE OF OWNER CHANGE 3 •� 11 <br /> ._._r_._r._! 9.3 INACTIVE <br /> Prior Owner 7C1rY-� 13a -lrw� 1�eCb� tt ��Q�viLe <br /> UNDER CONSTRUCTION CHANGE OF 8ILLiNG DATE OF BILLING CHANGE /._ / DELETE <br /> OWNER FILE <br /> OWNER ID �`� 76 CASE # S� BILLING PARTY <br /> OWNER NAME 6' C .l �V!If � G(,L r` p <br /> '�`r OWNER HOME PHONE C;2-d <br /> OWNER DBA OWNER WRK/BUS PH <br /> ADDRESS PU <br /> CITY 4`1✓�` STATE (f ZIP �-3 0 <br /> MAILING ADDRESStJJ 11C� L Cd <br /> : <br /> �p <br /> CARE OF �" N j S 1 G1 1,,za GG G-SII f� <br /> } <br /> CITY R); N ! �'f STATE C/�I ZIP Y i <br /> BUSINESS CODE NATURE OF OWNER BUSINESS e-� <br /> FACILITY FILE a <br /> FACILITY IDS BILLING PARTY ! H <br /> # OF EMPLOYEES <br /> FACILITY NAME G-G N Y� SfiiM-Lr�►�T �� L <br /> TRUST LANDS? Y. % N ,. <br /> FACILITY ADDRESS I S ` O (Pa I !v{. - HOME PH ( ?-4 <br /> CROSS STREET �'{'A AVG BUSH PH &2V '7 Ff <br /> CITY STATE G$ ZIP �S_;L0 I <br /> Census -------- 84S Dist location Cade.. City Code ------ <br /> MAILING ADDRESS 3 O X a �^ APN 9of 3 r-O a-p 3D <br /> CARE OF Y N C T G'U S`� Jfn 6:- N SIC CODE D <br /> CITY 3 a ,v ` STATE `" '- ZIP 1- 34 <br /> GENERAL TYPE of BUSINESS at this FACILITY 61 Al <br /> UST TAC STATUS CODE h(�� BUSINESS CODE /��` BUSINESS TYPE (UST) N C <br /> THIRD PARTY BILLING INFORMATION If <br /> NAME I�r HCME PHONE C ) <br /> MAILING ADDRESS ��" BUSH PHONE ( <br /> CARE OF N D <br /> !r i <br /> CITY � STATE IIP i� <br />