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Date run 3/16/2018 2:38:41PK SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 3/16/2018 <br /> Record Selection Criteria: Facility ID FA0022508 <br /> Make changes/corrections in RED'nk. <br /> INFORMATION CHANGE(date) J <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 1 SSNIFed Tax ID : <br /> Owner ID OW0020028 New Owner ID <br /> Owner Name DISH Network Corporation <br /> Owner DBA <br /> Owner Address r <br /> Home Phone Not Specified <br /> Work/Business Phone 303-723-1000 <br /> Mailing Address 9601 S. Meridian Blvd <br /> Englewood, CO 80112 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0022508 10441453 <br /> Facility Name DISH Network Manteca , <br /> Location t4ef5-E-Fl&4j;.Ayg_ (, /v <br /> Manteca, CA 95337 <br /> Phone 209-536-2120 x <br /> Mailing Address 11675 E Palm Ave <br /> Manteca, CA 95337 <br /> Care of Dish Network California Service Corporation <br /> Location Code Alt Phone <br /> BOIS District Fax <br /> APN 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 AR0041188 NewAccount ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name Accounts Payable (Circle One) <br /> Account Balance as of 3/16/2018: $213.00 <br /> (Circle One) <br /> Transfer to Aclivellnaclve <br /> Program/Element and Description Record ID Employee ID and Name Status Neli Owner/ Delete <br /> 1920-HMBP-Common Materials PR0540009 EE0000009-NICHOLAS LOEHRER Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR0539372 EE9999997-TWO VACANT2 Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andlor project specific,PHStEHD 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 and/or Standards and State anNor <br /> Federal Laws. <br /> APPLICANT'S 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 /> EHD Staff: ,o LZ_ Date Account out: L415 Date / / ! <br /> COMMENTS: <br /> Invoice#: <br />