Laserfiche WebLink
Date L212112115 1 :41:07AI SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report tle021 <br /> R. Pagel <br /> Facility Information as of 2/23/2015 <br /> Record Selection Crania. Facility ID FA0016696 pip <br /> FIU <br /> c Make changeslcorrections in RED ink.COPY <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 OW0013537 New Owner ID <br /> Owner Name G RATIO FARMS <br /> Owner DBA G RATTO FARMS <br /> Owner Address 537 YETTNER RD <br /> FRENCH CAMP, CA 95231 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-983-8537 <br /> Mailing Address N L- ILAS <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0016696 10185255 <br /> Facility Name G RATTO FARMS <br /> Location 537 YETTNER RD <br /> FRENCH CAMP, CA 95231 <br /> Phone 209-982-5686 x0 1 <br /> Mailing Addres l�Q U� 1 �� <br /> FRE=Tk'I-c�-•ane�`k--9&29 — [•1.Y� rte. ( .V-1 "IJ �LO <br /> care of G. RATTO Company <br /> Location Code 99- UNINCORPORATED P Alt Phone <br /> BOB District 001 -VILLAPUDUA, CARLOS Fax <br /> APN 19306005 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 AR0029578 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name G RATIO & CO (Circle One) <br /> Account Balance as of 2/23/2015: $79.00 <br /> (Circle One) <br /> Transfer o Active/Inactve <br /> ProgrannElement and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1958-HM-Farm Operations PRO624881 EE0008709-JAMIE DE LA ROSA Active Y N A I D <br /> 2830-AST FAC -SPCC EXEMPT PR0530599 EED002646-THUY TRAIN Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0533105 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT'. I,the undersigned owner,operator or agent of same,acknowledge that all site,anNor project specific,PIS/EI-D 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 applicabldtOMinance Codes ani Standards and State andror <br /> Federal Laws. �� <br /> Q�\) ,/ (}`v'^�QZ{_, k--'l �( / <br /> APPLICANT'S SIGNATURE: IM' yam! L 1 P�7k' "" �`� Date / V / s <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date / / <br /> Payment e Check Number Receive by <br /> REHS: MID _ Date,2�/ /� Account out: Date <br /> COMMENT . <br /> AS -Z�)1/1) <br /> s ( <br /> yd 0- <br /> AS <br /> AS iw f6 cv—b-6,t� <br />