Laserfiche WebLink
Date run 6/26/2008 10:05:35AI SAIVAQUIN COUNTY ENVIRONMENTAL*LTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 6/26/2008 <br /> Fill Selection Criteria. Facility ID FA0010122 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0008122 Case Number: H06655 New owner ID <br /> Owner Name ROD & CINDY KARNOFEL <br /> Owner DBA HONKER CUT MARINE <br /> Owner Address 11500 W EIGHT MILE RD <br /> STOCKTON, CA 95219 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-476-0103 <br /> Mailing Address 11500 W EIGHT MILE RD <br /> STOCKTON, CA 95219 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010122 <br /> Facility Name HONKER CUT MARINE <br /> Location 11500 W EIGHT MILE RD <br /> STOCKTON, CA 95219 <br /> Phone 209-476-0103 <br /> Mailing Address 11500 W EIGHT MILE RD <br /> STOCKTON, CA 95219 <br /> Care of <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN 071-190-03 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 AR0017122 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name ROD & CINDY KARNOFEL (Circle One) <br /> Account Balance as of 6/26/2008: $0.00 <br /> (Circle One) <br /> Transfer to Active/Ioacive <br /> Program/Element and Description Record ID Employee ID and Name Status New Omer? Delete <br /> 2220-SM HW GEN<5 TONS/YR PR0514180 EE0004636-GARRETT BACKUS Active Y N A _F__D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512410 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-OES PR0520084 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARIPR0510122 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATI\PR0528048 EE0004636-GARRETT BACKUS Inactive Y N 7G I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned ovmer,operator or agent of same,acknowledge that all site,and/or project speck,PHS/EHD hourly charges associated with this <br /> facility or activity will be billed to the party identified as the OWNER on this form. I also certify that all operations YOU be performed in accordance with all applicable Ordinace Codes and/or Standards and <br /> Stale and/or Federal Laws. VeF <br /> l <br /> APPLICANT'S SIGNATURE: Date „ p <br /> Program Records to be TRANSFERED: "$20.00= Amount Paid Date / / �/^''r,.�/,{-,lt/Y/) <br /> Water System to be TRANSFERED: "$372.00= Amount Paid Date_/ / <br /> Payment Type Check Number Recei y <br /> REHS: Date / / Account out: Date / O /g9r <br /> COMMENTS: <br /> \\phs-ehsql-nt\apps\envisions\reports\5021.rpt <br />