Laserfiche WebLink
Date run 5/30/2014 9:42:20AR SAN JOIN COUNTY ENVIRONMENTAL HEAL DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 5/30/2014 <br /> Recon Selection Criteria: Facility 10 FA0003877 <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 Not Specified <br /> Work/Business Phone 209-937-8460 <br /> Mailing Address 2500 Navy Drive <br /> STOCKTON, CA 95202-1997 <br /> Care of <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility lD/CERS ID FA0003877 10181501 <br /> Facility Name STOCKTON FIRE STATION #02 <br /> Location 110 W SONORA ST <br /> STOCKTON, CA 95203 <br /> Phone 209-944-8271 <br /> Mailing Address 425 N EL DORADO ST RM 312 <br /> STOCKTON, CA 95202 <br /> Care of STOCKTON CITY ACCTS PAYABLE <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 001 -VILLAPUDUA Fax <br /> APN 13731025 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 AR0003465 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name STOCKTON FIRE STATION #02 cinci one <br /> Account Balance as of 5/30/2014: $0.00 Na bh bl q <br /> (circa One) <br /> I Transfer to ActivellnacNe <br /> PrograMElemant and Description Record ID Employee ID and Name 'l— ( StaWa New Omer? Delete <br /> 22 AZ MAT BUSINESS PLAN AUTHORIZATION PR0512074 EE0000O00-HAZ MAT SJC DES Inactive Y N IV I D <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0231253 EE0000418-MICHAEL KITH Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PRO509786 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0528823 EE0001421 -STACY RIVERA Active,l Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO531758 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andior project specific,PHStEHD hourly charges associated wth this facility <br /> or activity will be billed to tha parry identified as the OWNER on this form. Ialso certify that all operations will be performed in accordance with all applicable Ordinance Codes and'or Standards and Stale 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 T Check Number Rece by <br /> RENS: n R—Z Date Account/ 6 Account out: Date / o /j_�_ <br /> COMMENTS: <br />