Laserfiche WebLink
Date run 2/11/2014;9:07:10;;FA001 <br /> jv� �COUNTYENVIRONMENTAL HEAi,�EPARTMENTRun by 1273 Report K5021 <br /> Is Facility Information as of 2/11/2014 P8Qel <br /> Re M Selection Criteria: 7o25 <br /> Make changes/corrections in RED Ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0013866 New Owner ID <br /> Owner Name C&G FARMS <br /> Owner DBA C&G FARMS <br /> Owner Address 3458 W LINNE RD <br /> TRACY, CA 95304 <br /> Home Phone Not Specified <br /> Work/Business Phone Not Specified <br /> Mailing Address 3458 W LINNE RD f —17 7 f) kl�NlE li <br /> TRACY, CA 95304''$c;3q13 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility lD/CERS ID FA0017025 10,185,775 <br /> Facility Name C&G FARMS <br /> Location 1777 W LINNE RD <br /> TRACY, CA 95304 <br /> Phone 209-835-2412 x0 <br /> Mailing Address 3458 W LINNE RD 1777 1i ,f hlhtF <br /> TRACY, CA 95304^'W�3 <br /> Care of <br /> Location Code 99- UNINCORPORATED P Alt Phone <br /> BOS District 005- ELLIOTT, BOB Fax <br /> APN 23922010 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 AR0029907 NewAccount ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name C&G FARMS (Chicle One) <br /> Account Balance as of 2/11/2014: $266.00 <br /> (Circle One) <br /> Transfer to Active/InaMe <br /> ProgramlElement and Description Record ID Employee ID and Name status New Owner! Delete <br /> 1958-HM-Farm Operations PRO525210 Active Y N A I D <br /> 2220-SM HW GEN<5 TONSNR PRO529361 EE0009001 -ELENA MANZO Active Y N A I D <br /> 2830-AST FAC -SPCC EXEMPT PRO529360 EE0009001 -ELENA MANZO Active,l Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO534534 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,end'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 andor Standards and Slate andor <br /> Federal Laws. <br /> APPLICANTS 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 Recei <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br />