Laserfiche WebLink
Date run 2/14/2017 5:00:33PA SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report *5021 <br />Run by Pagel <br />Facility Information as of 2/14/2017 <br />Record Selection Criteria: Facility ID FA0023859 <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 <br />OW0022284 New Owner ID <br />Owner Name <br />Pacific Gas & Electric Company <br />Owner DBA <br />Owner Address <br />Home Phone <br />Not Specified <br />Work/Business Phone <br />415-973-7000 <br />Mailing Address <br />c/o Environmental Services, 3401 Crow Canyc <br />San Ramon, CA 94583 <br />Care of <br />FACILITY FILE INFORMATION <br />Facility ID / CERS ID <br />FA0023859 10724686 <br />Facility Name <br />PG&E - Stockton Anchor Yard <br />Location <br />3200 E Eight Mile Rd <br />Stockton, CA 95212 <br />Phone <br />X <br />Mailing Address <br />PO Box 7640 <br />San Francisco, CA 94120 <br />Care of <br />Pacific Gas & Electric Yard <br />Location Code <br />Alt Phone <br />BOS District <br />Fax <br />APN <br />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 AR0044225 <br />Mail Invoices to Account Mail Invoices to: <br />Account Name PG&E - CUPA Permits (REF: Stockton Anchor Yard) <br />Account Balance as of 2/14/2017: $0.00 <br />New Account ID: : <br />Owner / Facility / Account <br />(Circle One) <br />(Circle One) <br />Transfer to Active/Inactve <br />Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br />1920 - HMBP-Common Materials PRO541631 EE0008709 - JAMIE LIMA Active Y N A I D <br />BILLING and COMPLIANCE ACKNOWLEDGEMENT. I, the undersigned owner, operator or agent of same, acknowledge that all site, and/or project specific, PHS/EHD 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: <br />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 Received by <br />EHD Staff: �1�1 r Date v l `1 / 1 Account out: Date a 1, l l <br />COMMENTS: 0291 j y <br />GW -TC-V <br />q -e(- cf-,D 5 <br />�J� �-A-�t f,t <br />�r-J <br />S�P"'TTAI- <br />A-- ? P;-� A FYI <br />(7,0/t-1 <br />Invoice #: <br />