Laserfiche WebLink
Dale nun 12/16/2014 4:24:25P SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Repo"#5021 <br /> Run by 1273 ' Pagel <br /> Facility Information as of 12/16/2014 <br /> Record Selection Criteria: Facility ID FA0003365 <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/Fed Tax ID : <br /> Owner ID OW0002489 Case Number: 002448 New Owner ID <br /> Owner Name C M L BORBA RANCH INC <br /> Owner DBA <br /> Owner Address 23335 E DODDS RD .2--5';7S <br /> ESCALON, CA 95320 gni�py� Lf3 9y3yo <br /> KA <br /> Home Phone Not Specified <br /> Work/Business Phone 209-838-1648 <br /> Mailing Address 23335 E DODDS RD <br /> ESCALON, CA 95320 <br /> Care of BORBA, LAWRENCE; BORBA, MIKE <br /> FACILITY FILE INFORMATION <br /> Facility to/CERSID FA0003365 10181115 <br /> Facility Name C M L BORBA RANCH INC 39-347 <br /> Location 23335 E DODDS RD <br /> ESCALON, CA 95320 <br /> Phone 209-838-7737 <br /> Mailing Address 23335 E DODDS RD <br /> ESCALON, CA 95320 <br /> Care of <br /> Location Cade 99- UNINCORPORATED P Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> APN 20716004 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title p <br /> Day Phone 209-838-7737 <br /> ON <br /> Night Phone <br /> DEC 16 2014 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0002942 ENUIRONMENfi HEN�iH <br /> New Account ID: <br /> Mail Invoices to <br /> Facility pEflMl7/SERVICE$ Mail Invoices to: Owner / Facility / Account <br /> Account Name C M L BORBA RANCH INC 39-347 (Circle One) <br /> Account Balance as of 12/16/2014: $0.00 <br /> (Circle One) <br /> ProgrendElement and DescriptionRecord ID Employee ID and Name Status Transfer to Active/Inacive <br /> New Owne/I Delete <br /> 1958-HM-Farm Operations PR0525785 EE0002474-MICHAEL PARISSI Active Y N A I D <br /> 2011-GRADE A DAIRY PR0200060 EE0004589-KADEANNE LINHARES Inactive Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR0530160 EE0001421 -STACY RIVERA Active Y N A I D <br /> 2765-EMPLOYEE HOUSING-PERMANENT>180 DAYS PR0515642 EE0002089-OMRAN SOOD Active Y N A I D <br /> 2830-AST FAC -SPCC EXEMPT PRO530159 EE0001421 -STACY RIVERA Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO533190 Inactive Y N A I D <br /> 4617-EMPLOYEE HOUSING-WATER SUPPLY WA0516736 EE0004589-KADEANNE LINHARES Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,Me undersigned owner,operator or agent of same,acknowledge that all site,andior project specific,PHSIEHD hourly chargee associated wth this facility <br /> or activity will be billed!to the party identified as Me OWNER on this Mnn. I also certify Met all operations will be performed in accordance with all applicable Ordinance Cordes ander Standards and State andor <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type Check Number Reoei a by <br /> REHS: Date / / Account out: / J Date <br /> COMMENTS: <br />