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** PLEASE CHECK LOOKUP - if good, then Approve QCStatus, else update with correct RECORD_ID (8)
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
W
>
WILSON
>
3550
>
4200 – Liquid Waste Program
>
PR0505453
>
** PLEASE CHECK LOOKUP - if good, then Approve QCStatus, else update with correct RECORD_ID (8)
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Last modified
12/10/2021 12:25:45 PM
Creation date
12/10/2021 12:22:06 PM
Metadata
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EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
PR0505453
PE
4242
FACILITY_ID
FA0006451
FACILITY_NAME
OPEN AIR MALL
STREET_NUMBER
3550
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
13207012
CURRENT_STATUS
01
SITE_LOCATION
3550 N WILSON WAY
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\tsok
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EHD - Public
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V -900 -b! -i /oq'1x- <br />Sign here fcx-, O`' — Date 11/18/2021 <br />THREE DAY RIGHT TO CANCEL <br />'Only applies if the contract is greater than $750. <br />Sign here Date <br />CUSTOMER ACKNOWLEDGEMENT <br />COMPLETION I acknowledge completion of the above described work which has been done to my complete satisfaction. <br />Sign here <br />Date 11/18/2021 <br />I authorize Roto -Rooter to charge the agreed amount to my credit card provided herein. I agree that I will pay for this <br />purchase in accordance with the issuing bank cardholder agreement. <br />Sign here — — Date 11/16/2021 <br />Sign here <br />TECHNICIAN ACKNOWLEDGEMENT <br />Date 11/18/2021 <br />Sign here Date 11/18/2021 <br />
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