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Date run 10/17/2018 3:36:09F SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> FacilitvAnforniation as of 10/17/2018 <br /> a <br /> Record Selection Criteria: Facility ID FA0017314 <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: 1 SSN/Fed Tax ID <br /> Owner ID OW0014155 New wner ID <br /> Owner Name D J CATON DAIRY S <br /> Owner DBA D.J. CATON DAIRY <br /> Owner Address 2712 OAKHURST DR <br /> OAKDALE, CA 953619233 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-456-3366 <br /> Mailing Address 2712 OAKHURST DR �17kt <br /> OAKDALE, CA 95361-9233 3,- <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0017314 10186255 �� nZca'mS <br /> Facility Name D J CATON DAIRY <br /> Location 15635 STEINEGUL RD <br /> ESCALON, CA 95320 <br /> Phone 209-847-5299 x0 <br /> Mailing Address 2712 OAKHURST DR /Sad tG <br /> OAKDALE, CA 95361-9233 CS Lk.1 D-n S3 ZU <br /> Care of D.J. Caton <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN 22909005 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 AR0030196 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name D J CATON DAIRY (Circle One) <br /> Account Balance as of 10/17/2018: $350.00 <br /> (Circle One) <br /> Transfer to Active/Inaclve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1958-HM-Farm Operations PR0525499 EE0002670-MUNIAPPA NAIDU Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR0530108 EE0000032-JOHN ALANIZ Active Y N A I D <br /> 2840-AST EXEMPT FAC < 1,320 GAL PR0530107 EE0002670-MUNIAPPA NAIDU InactivE Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0532965 InactivE Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/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 and/or Standards and State and/or <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: Date / / Account out: Date <br /> COMMENTS: <br /> Invoice#: <br />