Laserfiche WebLink
SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES - ENVIROIDIENTAI, HEALTH DIVISION <br /> HASTERFILE RECORD INFORMATION FORM ' <br /> EH 01 15 (OWNFAC) Ravie n <br /> NEW FACILITY CHANE <br /> OF OWNElt DATE Of OMER CHANGE INACTIVE <br /> Prior Omar <br /> UNDER CONSTRUCTION CHANCE OF of <br /> DATE OF BILLING CHANGE DELETE <br /> OWNER FILE <br /> OMER IO <br /> CASE Rt BILLING PARTY <br /> G�/ m <br /> O MER NAME <br /> I i- A . A-h l►r �, r�-� "OIINER NOINI PNOIE ( �/6 ?SN -�•. <br /> OWER DBA n Ct <br /> OWNER YRK/N X PN ( <br /> ADDRESS 0 / <br /> CITY _Il f►.r �A /t�u�i-2'��0- /� <br /> STATE C_/�_'...np 9s6Y3 <br /> NAILING ADDRESS <br /> CARE Of <br /> CITY - <br /> STATE ZIP <br /> NUSlNESS CODE NATURE OF OWNER BUSINESS <rA <br /> FACILITY FILE <br /> =-Y <br /> BTLLINQ PARTY <br /> FACILITY NAME1 . OF EMPLOYEES T <br /> TRUST LAHDST Y / Y <br /> FACILITY ADDRESS j S C <br /> �.,. a & e., e <br /> HOME Pb <br /> CROSS STREET U <br /> BUSH PM <br /> S� ZIP •�-, _ <br /> CRN1W{ •---••-•• NOS Dist. ; <br /> Location Coda. _ <br /> City Code <br /> MAILING ADDRESS <br /> APM <br /> 0-I <br /> CANE OF <br /> CITY ... <br /> SIC <br /> CI <br /> STATE ZIP <br /> GENERAL TYPE of BUSINESS at this FACILITY <br /> I <br /> FUST FAC STATUS CODE <br /> BUSINESS COOS BUSINESS TYPE (UST) <br /> THIRD PARTY BILLING INFORMATION <br /> NAME <br /> HOME PHONE ( ) <br /> NAILING ADDRESS <br /> BUSH PHONE-( ). <br /> CARE OF <br /> _._, 10A <br />