BILLING - Laserfiche WebLink

Home Browse Search

-- ------------ -- ---------- ------------ Dale run 2118/2014 10:01:11AI SAN JOY TIN COUNTY ENVIRONMENTAL I HEAU DEPARTMENT Report 95021 Pagel Run by 1273 Facility Information as of 2/18/2014 Record Selection Criteria: Facility ID FA0010986 Make chang6s[corrections in RED ink. INFORMATION CHANGE(date) OWNERSHIP CHANGE(date) OWNER FILE INFORMATION SSN/Fed Tax ID owner ID OW0012761 New owner ID Owner Name OLDCASTLE PRECAST-INC Owner DBA Owner Address 1002 15TH ST AUBURN, WA 98001 Horne Phone 253-833-2777 Work[Business Phone 209-858-0225 Mailing Address 15540 S MCKINLEY RD LATHROP, CA 95330 rvli�Sk 4. Care of RO'e't FACILITY FILE INFORMATION Facility ID/CERS ID FA0010986 10,184,013 Facility Name OLDCASTLE PRECAST Location 15540 S MCKINLEY RD LATHROP, CA 95330 Phone 209-858-0225 Mailing Address 15540 S MCKINLEY RD 7- K LATHROP, CA 95330 Care of Location Code Alt Phone BOS District 003-BESTOLARIDES Fax APN 19806010 EMail: EMERGENCY NOTIFICATION CONTACT INFORMATION Contact Name ERNEST JORDAN Title PLANT MANAGER Day Phone 209-858-0225 i r Night Phone 209-495-0796 ACCOUNTS RECEIVABLE FILE INFORMATION Account ID AR0017986 New Account ID: Mail Invoices to Facility Mail Invoices to: Owner I Facility I Account Account Name OLDCASTLE PRECAST (Circle One) Account Balance as of 2118/2014: $923.00 (Circle One) Transf6tto Active/Inacive Program/Element and Description Record ID Employee ID.and Name Status New Owner? Delete 1921 -HMBP-Regular-Primary Location PRO513274 EE0002474-MICHAEL PARISSI Active Y N A I D 2220-SM HW GEN<5 TONSNR PR0528654 .EE0002646-THUY TRAN Active Y N A I D 2399_-UNIFIED PROGRAll STATE SURCHARGE F 'PRO510986 LEOOOOOOO-HAZ MAT SJC OES Inactive Y N A I D 2840-AST EXEMPT FAC < 1,320 GAL PRO528653 EE0002646-THUY TRAN Actl Y N 'A I D ERSC-ELECTRONIC REPORTING STATE SURCHARG 'PR0533334 Inactive y N A I D BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge that all site,ancilor project specirc.PH&EHO hourly charges associated with this facility 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 andlor Standards and Slate andfor Federal Ums, APPLICANTS SIGNATURE: Date Program Records to be TRANSIl $25.00= Amount Paid Date Water System to be TRANSFERED: Amount Paid Date Payment Type Check Number Rece /, Date Date Account out: Date COMMENTS: J ak"