Laserfiche WebLink
Date run 2/25/2015 10:42:39AI SAN JO&IN COUNTY ENVIRONMENTAL HEA*DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 2/25/2015 <br /> Record Selection Criteria: Facility ID FA0010348 <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: 86 SSN/Fed Tax ID <br /> Owner ID OW0001176 New Owner ID <br /> Owner Name CITY OF STOCKTON <br /> Owner DBA <br /> Owner Address 425 N EL DORADO ST <br /> STOCKTON, CA 95202 <br /> Home Phone 209-937-8212 <br /> Work/Business Phone 209-937-8341 <br /> Mailing Address 425 N EL DORADO ST <br /> STOCKTON, CA 95202 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility lD/CERS ID FA0010348 10183471 <br /> Facility Name CITY OF STOCKTON FIRE STATION#14 <br /> Location 3019 MCNABB ST <br /> STOCKTON, CA 95209 <br /> Phone 209-937-8801 x <br /> Mailing Address 3019 MCNABB ST <br /> STOCKTON, CA 95209 <br /> Care of STOCKTON FIRE DEPARTMENT#14 <br /> Location Code Alt Phone <br /> BOB District Fax <br /> APN 06808005 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0017348 New Account ID: <br /> Maillnvoicesto Account Mail Invoices to: Owner / Facility / Account <br /> Account Name CI KTON I E EPARTMENT (Circle One) <br /> Account Balance as of 2/25/1-01 <br /> (Circle One) <br /> Transfer to Activelinactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1920-HMBP-Common Materials PR0539664 EE0000006-HAZA SAEED Active,l Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512636 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PR0510348 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2840-AST EXEMPT FAC <1,320 GAL PR0528818 EE0000005-FATINAH ZAREEF Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andor 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.lhal all operations will be performed in accordance with all applicable Ordinance Codes andfor Standards and Slate and/or <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 Received by <br /> REHS: Date�L/7i5/ l Account out: - Date <br /> COMMENTS: ^ <br />