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Date on 11/24/2014 11:33:51/ SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report SM21 <br /> Run by Pagel <br /> Facility Information as of 11/24/2014 <br /> Record Selection Criteria. Facility ID FA0017317 <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 OW0014158 New Owner ID <br /> Owner Name EMANUELFRANCESCHETTI <br /> Owner DBA EMANUELFRANCESCHETTI <br /> Owner Address 17266 STEINEGUL RD <br /> ESCALON, CA 95320 <br /> Home Phone Not Specified <br /> Work/Business Phone Not Specified <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 x0 <br /> Mailing Address 17266 STEINEGUL RD <br /> ESCALON, CA 95320 <br /> Care of <br /> Location Code Alt Phone <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 <br /> Account ID AR0030199 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name EMANUELFRANCESCHETTI (Circle One) <br /> Account Balance as of 11124/2014: $0.00 <br /> (Circle One) <br /> Transfer to Active/InecNe <br /> Program/Element and Description Record ID Employee ID and Name status New OwoeR Delete <br /> 1958-HM-Farm Operations PR0525502 Active Y N A I D <br /> 2840-AST EXEMPT FAC < 1,320 GAL PR0530101 EE0000753-WILLY NG Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO533600 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,PHSIEHO hourly charges associated with this facility or: <br /> W billed to the Perry identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinance Codes andor Standards and State andor 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 /> REHS: Date_/ / Account out: Date_/ / <br /> COMMENTS <br />