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San Joaquin County Environmental Health Department <br /> Operating Permit Form <br /> Ay Name Hob Nob <br /> Site Address 1114 N Main St CityManteca state CA zIP95336 <br /> Business Phone 209 328-1595 SSN or Tax IDq <br /> 559-85-2821 <br /> Facility Mailing Address 1114 N Main St city Manteca state CA ZIP 95336 <br /> If mobile food truck or License Plate Number VIN <br /> pumper truck <br /> Facility Owner <br /> First Name Last name <br /> Jason Messer <br /> Home Address 3915 Castellina Way city Manteca State CA ZIP 95337 <br /> Mailing Address same City State ZIP <br /> Phone 209.406-4128 Phone 209.406-0366 Email <br /> Billing Party <br /> First Name Jason Lae-name Messer <br /> Billing Address 3915 Caste[lina Way "'Manteca State CA Z'J5337 <br /> Phone 209.406-4125 Phone Email <br /> BILLING AND CQMPLIANGE ACKNOWLEDGMENT: 1,the undersigned Applicant, certify that I am the Owner, Operator,or Authorized Agent of this <br /> Business,and I acknowledge that all PERufTFEES,PENALi7ES,EWFORcawENT CHARGES and/or HOURLY CHARGES associated with this operation will <br /> be billed to meat the address identified above as the B)LLiNGAODRESS for this site. 1 also certify that all information provided on this application <br /> is true and correct;and that all regulated activities will be performed in accordance with all applicable SAN JOAQUIN COUNTY Ordinance Codes <br /> and/or Standards and STATE and/or FEDERAL Laws and Regulations. <br /> Applicant Name Jason Messer Signature <br /> jafon e,ss2Y <br /> Title Rate Dffve S tlepro <br /> Owner 1 1 1712 0 24 c6631754 <br /> {Photocopy Required) <br /> EHD Use Only <br /> Assigned To f�' Linked FA ID --FRecord Number <br /> Date D� PE !6 7- Fee 5� <br /> Permit Valid from 1 I "] <br /> CJ Amount Paid Payment Received By <br /> ❑Cash <br /> ❑Check# C�-'D <br /> �Confil!`MaWrkVVVV <br /> PAYMENT <br /> RECEIVED <br /> NOV 0 7 2025 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> 'P2 0� W J-U 3 X F,)' <br />