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.�.roaaieaeti rut. +1(209)944-9812 Pggo 2 or t Wl9(206e 4A9 <br /> .SAN JOAQLAN COLWrY ENVIRONMBiffAL HF_ALrK&CFAR1T lT <br /> IIKUS ERFILE RECORD INFORMA-nON FWA <br /> - <br /> nk',4%, i�b M.?,.2k^rt W tK'R�!:-1�'nwi¢n1�`�'4�jN ��C .1.er li 4Fb5i��' �y„�u� +r MYW ,,`li✓ +'i,,.9�J;�t?�r. <br /> OWNER FILE <br /> R71wtEfL�71yr ACXL0ffAfG8USlNEs60WNERIAMRAK7AYv: CAWKWOWNERCt.Rr&01.vavFar+wrrf <br /> BUSINESS <br /> OKWER'$NAIIIE hn E Y1u 111 s FHONE:(209) 944-tl509 <br /> r.x rAr ciat <br /> WJSllN�B NAME(H�N,.,.,trrsxoyrrr�rrN <br /> Tdoalease 8oc 9so arra«A?r <br /> CWVN 'S HOME ADDRESS 1133 Er,(stol Avonue <br /> =OTY <br /> 8tocktcn $,ASE 7jP <br /> OMrEH"8IN1111N6Af10R�8(if&o*, rttjr nOwlwaAddrNai C� 9d"l <br /> Adsivi0ft o'Osn A <br /> MAILING AI00MESSS QTY <br /> STATE Z P <br /> Rrvo Qww r. <br /> ('itXtl'ONATtlN❑ INeIYIptIAL� PANrUMW41r LonALAQ.1 Y❑ C0kJWr1'AO&4r STATEAQw4oy❑ FwAaI9c0YCI o11Bi'❑ <br /> U 1 1 v FACILI7 y mis <br /> @� 0 3.5 I o b <br /> } `7'I i :`�.M aa�i^+�(�.`r .v l't,.-, . d "1�, '': '�C,i'�'�� '.11-.y1 a ', u 1+ ' n in <br /> �-.: Ja`.h-^:,=3�.r ,dM:r � ;(zXdd rtal�n�.ti}�. <br /> C FYETFTRBFOUtAwA BUSINESS FACILITY Argrraw <br /> Lvtfna a NqY Bus Nees l.crdwTpN or vpipLp not pnvbtrbr rrpulpted lry the ENwroNweNrALMeuTH D9Altrall[Hr? YEs [] No X <br /> Q <br /> bthis an EAeTmo 811rirwae LGGATMk tWt a MW Trr6 ct rrauUdod BW kw"? Y6 No �] <br /> BUW UM&FACIUTY NAME Mli.wn be ttm&mN=Nm*m the HEOLTH PEHMT) <br /> Tdaalc�ase <br /> FKNUfYAPIX�'BB(1(FACenYMiMr�tfarotNlrw'FIXADVeaa�lYe@I► ) <br /> 1137 southg�a'10spH3NE <br /> 9tnekt on Street (209) 944-0709 <br /> QTY(HFicwrvwa ilt"acelmuNvra v <br /> Fan VuacYsuw tfrr_.•�,��•�.,Ori M <br /> 9toClCCon STATE YIP <br /> Q4 <br /> 95205 <br /> A6aLMq AeaaEsa titiw f'fmI/Eh }"�" "� T'Y tdr '"' <br /> f4lrtNtpfaturesrrnTr,emFeriiya,ps.,�� AthrrtlraraVp of V <br /> Mark 3uller <br /> MAILIN3 AWRMs QTY I <br /> 5raTF zIP <br /> 6CCO0fTAppffFS&farfees MWCh&rges: OWNER Q FAaurf)B=Nvss1111.1-1140 AND Co ANCL,AeilrjMrDGMEW� Q <br /> I.she undsniyned Applicant curtly that I am the OWner Operator,or Au#wiZod Agent of alis Ousiness and l <br /> acknowledge that ail PEgMR Psly,PENALryty,97 CRC 547 CnARGe4 andh r Hwm.r t.71nacGg assaclated wlth this Operation will be bilbd to ma at the <br /> a guldt0 aGdvled above ,Pert Acceuni accagksstor Ihlc shs. I oleo cwtify that ail IrYannation provided on thiaappticauon k true and corset)and that all <br /> regulated Rogu tes will ba pedonnsd in accordance Wgh al aPIP"bla SAN JoACKM COLIM Ordinance Codes andlor Smndarde and S-FATF anevor FmEtAL <br /> Laws aratM uWtlare, <br /> APRJCANT'SNM1E; Mirk Huller SIQNAntRE, t/\ <br /> pre Albl <br /> Tom: Manager DATE���.? � DwvtuYa Lroatwar .� <br /> Y Cl <br /> '^>�'" �4�'t:".��•� 4".�...`.� ��:::r �4...M1T'ti s"�$r1`P �.:n T"'ri'' F r...�.,,, e.r�r= -�� �rH. {�i �� r r v �erf'd�r ✓� i <br /> ' ... .. . ti' r•..rr-'i�s.r'c.a�niR�Fryy rA.�r�n.'" ��r 1�F°�`rrVM1'�n�.r���,Yry�t��r it sr <br /> A PNoaaAr (E (�.654$4VR0B Or rQt Svetmr(Et'ID K!-pg.ppyl io[rnwry be <br /> bled fOr 4I4 <br /> II EI1D raauksted ol"ra m it this,Ur ]lpb <br /> ° s CONFIDENTI <br /> 1127ro7 tarWe Mecord-Green <br />