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!7 ^' Date run 4/19/2016 11:14:51AI SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 Run by Pagel Facility Information as of 4/19/2016 Record Selection Criteria: Facility ID FA0017387 OWNER FILE INFORMATION Number of facilities for this owner: 1 Owner ID OW0014228 Owner Name H J HEINZ CO Owner DBA H.J. HEINZ CO Owner Address 6755 C E DIXON ST Phone STOCKTON, CA 95206-4947 Home Phone 209-333-0580 Work/Business Phone 209-487-3210 Mailing Address 2800 S EL DORADO ST Location Code STOCKTON, CA 95206-3270 Care of Fax FACILITY FILE INFORMATION Make changes/corrections in RED ink. INFORMATION CHANGE (date) OWNERSHIP CHANGE (date) SSN / Fed Tax ID New Owner ID : Facility ID! CERS ID FA0017387 10186373 Facility Name H J HEINZ CO Location 9900 S JACK TONE RD STOCKTON, CA 95215 Phone 209-943-8460 x Mailing Address 6755 CE Dixon St Status STOCKTON, CA 95206-3270 Care of Heinz Location Code Alt Phone BOS District Fax APN 20302004 EMail: EMERGENCY NOTIFICATION CONTACT INFORMATION Contact Name Title Day Phone Night Phone ACCOUNTS RECEIVABLE FILE INFORMATION Account ID AR0030269 Mail Invoices to Account Mail Invoices to Account Name H J HEINZ CO Account Balance as of 4/19/2016: $53.00 New Account ID: : Owner / Facility / Account (Circle One) Program Records to be TRANSFERED: Water System to be TRANSFERED: Payment Type Check Number EHD Staff: COMMENTS " $25.00 = Amount Paid Date Amount Paid Date / ! Received by Date / / Account out: Date Invoice #: (Circle One) Transfer to Active/Inactve Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete 1958 - HM -Farm Operations PR0525572 EE0002670 - MUNIAPPA NAIDU Active Y N A I D 2220 - SM HW GEN <5 TONS/YR PR0538573 EE0009001 - ELENA MANZO Inactive Y N A I D 2830 - AST FAC - SPCC EXEMPT PR0528907 EE0009001 - ELENA MANZO Inactive Y N A I D ERSC - ELECTRONIC REPORTING STATE SURCHARG PR0532129 Inactive Y N A I D 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 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 Federal Laws. APPLICANT'S SIGNATURE: Date Program Records to be TRANSFERED: Water System to be TRANSFERED: Payment Type Check Number EHD Staff: COMMENTS " $25.00 = Amount Paid Date Amount Paid Date / ! Received by Date / / Account out: Date Invoice #: