Laserfiche WebLink
Datemn /23/2015 :37:12AI SAN JCS tUIN COUNTY ENVIRONMENTAL HEA H DEPARTMENT Report#5021 <br /> RW by - Facility Information as of 2/23/20015 Paget <br /> Record Selection Choirs: Facility ID FA0019475 <br /> Make changeslcorrections in RED Ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 3 SSN/Fed Tax ID : <br /> Owner ID OW0014255 New Owner ID <br /> Owner Name S PELLEGRI & SONS <br /> Owner DBA S PELLEGRI & SONS <br /> Owner Address 8074 W DELTA RD <br /> TRACY, CA 95304 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-835-5718 <br /> Mailing Address 8074 W DELTA RD <br /> TRACY, CA 95304 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0019475 10187259 <br /> Facility Name S PELLEGRI & SONS <br /> Location 21606 EL RANCHO <br /> TRACY, CA 95304 <br /> Phone 209-835-5718 x <br /> Mailing Address 8074 W DELTA RD <br /> TRACY, CA 95304 <br /> Care of S PELLEGRI & SONS <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN 21318047 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 AR0034625 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name S PELLEGRI & ONS (CimleOne) <br /> Account Balance as of 2/23/2015: $53. <br /> (Clide One) <br /> Transfer to Activellnadve <br /> Program/Element and Description Record ID Employee ID 911d Nam Status New OwneY1 Delete <br /> EE000247 -MIE;!wailaipplicable <br /> Active Y N A I D <br /> ERSC- NG STATE SU PR0531786 Inacliv( Y N A D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT I,the undersigned owner,operator or agent of same,adnowlads it charges associated with this facility <br /> oradivity will be billed to the party identified as the OWNER on this form. IelsD certify that all operations will be performed Ordinance Codesan rds and State anclor <br /> Federal Laws. <br /> APPLICANTS SIGNATURE: <br /> Program Records to be TRANSFERED: '$25.00= Date / / 1 � ur- <br /> Water System to be TRANSFERED: Amount Paid Date / / <br /> Payment^TTynRe __ Check Number - Received by <br /> REHS: N�C�[J1Date 3_/ Z /_jc5_ Account out: �A�J Date 12-0115- <br /> COMMENTS: ZD / 15COMMENTS: <br /> A 14-oc-m- A5 7lb <br />