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` Report#5021 <br /> Date run 1/12/2018 8:07:57AK SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Paget <br /> Run by Facility Information as of 1/12/2018 <br /> Record selection Criteria: Facility ID FA0017317 <br /> Make changesicorrections 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 OW0014158 New Owner ID <br /> Owner Name EMANUEL FRANCESCHETTI <br /> Owner DBA EMANUEL FRANCESCHETTI <br /> Owner Address 17266 STEINEGUL RD <br /> ESCALON, CA 95320 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-838-7888 <br /> Mailing Address 17266 STEINEGUL RD <br /> ESCALON, CA 95320 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0017317 10186259 <br /> Facility Name EMANUEL FRANCESCHETTI <br /> Location 17266 STEINEGUL RD <br /> ESCALON, CA 95320 <br /> Phone 209-838-7888 X <br /> Mailing Address G./ 6 <br /> Care of Emanuel Franceschetti <br /> Location Code S Alt Phone <br /> F <br /> BOS District Fax <br /> APN 22925002 Email: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION New Account ID: <br /> Account ID AR0030199 <br /> Mail Invoices to: Owner / Facility / Account <br /> Mail Invoices to Account curie one) <br /> Account Name EMANUEL FRANCESCHETTI <br /> Account Balance as of 1/12/2018: $96.00 (Circle one) <br /> Transferto Activellnactve <br /> ProgreMElement and Description Record ID Employee ID and Name <br /> Status New Owner Delete <br /> 1958-HM-Farm Operations PR0525502 EE0002670-MUNIAPPA NAIDU Active Y N A I D <br /> PRO530101 EE0000763-WILLY NG Inactive Y N A I D <br /> ERS -AST EXEMPT FAC < GAL Inactive Y N A I D <br /> RSC-ELECTRONIC REPORTING STATE SURCHARG PR0533600 angor protect specific. hourly charges associated with this facility <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator a agent ti same,acknowledge that ell site, p I P <br /> or activity will be billed to the party idenli0etl--the OWNER on this form. I also certify that all operations will be pertormetl In accordance with all applicable ordinance Codes enNor Standards and State ardor <br /> Federal Laws. <br /> Date <br /> APPLICANT'S SIGNATURE: <br /> Program Records to be TRANSFERED: "$25.00= Amount D <br /> ate <br /> Amount Paid Date /— <br /> Water System to be TRANSFERED: Received by <br /> Payment Type Check Number <br /> Date_/_/— Account out: �� Date_L__/ �a <br /> EHD Staff: / <br /> nvoice <br /> COMMENTS: <br /> #: <br /> �4. \tN� ar t�rtsS Gkc%,jsc at Per P-e_kVI, ✓\ ,wlk <br />