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Date run 3112/2015 8:56:08AN SAN X UIN COUNTY ENVIRONMENTAL HEA I DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 3/12/2015 <br /> Record Selection Criteria: Facility ID FA0016974 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER. FILE INFORMATION Number of facilities for this owner : 1 SSN I Fed Tax ID <br /> Owner ID OW0013815 New Owner ID <br /> Owner Name GREG RATTO FARMS <br /> Owner DBA GREG RATTO FARMS <br /> Owner Address 2252 SHERIDAN WAY <br /> STOCKTON, CA 95207 <br /> Home Phone Not Specified <br /> Work/Business Phone Not Specified <br /> Mailing Address 2252 SHERIDAN WAY <br /> STOCKTON, CA 95207 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID I CERS ID FA0016974 10185705 <br /> Facility Name GREG RATTO FARMS <br /> Location 9483 S BORBA RD <br /> STOCKTON, CA 95206 <br /> Phone 209-952-3815 x0 <br /> Mailing Address 2252 SHERIDAN WAY <br /> STOCKTON, CA 95207 <br /> Care of <br /> Location Code 99 - UNINCORPORATED F Alt Phone <br /> BOS District 003 - BESTOLARI DES, STEVE Fax <br /> APN 16208004 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0029856 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner J Facility 1 Account <br /> Account Name GREG RATTO FARMS (circle One) <br /> Account Balance as of 311212015: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> PrograMlEleruent and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1958-HM-Farm Operations PRO525159 EE0009817-ROBERT LOPEZ Active Y NI�D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO532453 Inactiv( Y N A 4 D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,,acknowledge that all site,and/or project specific,PHSIEHD hourly charges associated with this facility <br /> or activity will be billed to the party identified as the OWNER on this form I also certify that all operations will be performed in accordance with all applicable Ordinance Codes and/or Standards and State and/or <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: Date J J <br /> Program Records to be TRANSFERED: "$25.00 v Amount Paid Date 1 1 <br /> Water System to be TRANSFERED: Amount Paid Date 1 1 <br /> Payment Type Check Number Received b <br /> REHS: Date Account out: _� Date 5 1 115 <br /> COMMENTS: <br />