Laserfiche WebLink
Date run 11/6/2013 2:57:06PR SAN JO JIN COUNTY ENVIRONMENTAL HEAI ' DEPARTMENT Report#5021 <br /> Run by �"' `"W Pagel <br /> Facility Information as of 1116!2013 <br /> Record Selection Criteria: Facility ID FA0014692 <br /> Make changeslcorrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0011703 New Owner ID <br /> Owner Name HOUSLEY FAMILY INVEST LLC <br /> Owner DBA HOUSLEY'S CENTURY OAK WINERY <br /> Owner Address 5050 SILVERADO <br /> NAPA, CA 94558 <br /> Home Phone Not Specified <br /> Work/Business Phone 707-253-7629 <br /> Mailing Address 5050 SILVERADO <br /> NAPA, CA 94558 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0014692 10,184,743 <br /> Facility Name HOUSLEYS CENTURY OAK WINERY <br /> Location 22211 N LOWER SACRAMENTO RD <br /> ACAMPO, CA 95220 <br /> Phone 209-334-3482 x0 <br /> Mailing Address 5050 SILVERADO <br /> NAPA, CA 94558 _ <br /> Care of <br /> Location Code 99 - UNINCORPORATED A Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> APN 01314046 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 AR0024999 New Account.ID: <br /> Mail Invoices to Owner Mail Invoices to, Owner I Facility I Account <br /> Account Name HOUSLEY FAMILY INVEST LLC (Circle One) <br /> Account Balance as of 111612013: $0.00 <br /> (Circle One) <br /> Transfer to Activellnai <br /> Prograrn/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Reqular-Primary Location PR0521618 EE0008709-JAMIE DE LA ROSA Active Y N A 0 D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0531395 Inactive Y N A 1 D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific,PHSIEHD 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 perfermed in accordance with all applicable Ordinance Codes andlor Standards and state and'or <br /> Federal Laws <br /> APPLICANT'S SIGNATURE. Date / I <br /> Program Records to be TRA'NSFERED: *$25.00= Amount Paid Date ! ! <br /> Water System to be TRANSFERED Amount Pald Date 1 I <br /> Payment Emil, <br /> Check Number Received by <br /> REHS:S L mil,e- csah�tPk— — _ Date 10(fl Account out: Date 77' <br /> 43 <br /> COMMENTS: <br /> Rv(�- 10 13 <br />