Laserfiche WebLink
ERecord <br /> 8/20/2008 9:3;15131,clA SAN JC UIN COUNTY.ENVIRONMENTAL HEA I DEPARTMENT Report#5ozr <br /> Facility Information as of 8/20/2008 Pagel <br /> ection Crileria: FFA0019058 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNER FILE INFORMATION OWNERSHIP CHANGE(date) <br /> SSN/Fed Tax ID <br /> Owner ID OW0002413 New Owner ID <br /> Owner Name TRACY, CITY OF <br /> Owner DBA CITY OF TRACY <br /> Owner Address 325 E TENTH ST <br /> TRACY, CA 95376 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-831-4100 <br /> Mailing Address 325 E TENTH ST <br /> TRACY, CA 95376 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019058 <br /> Facility Name TRACY FIRE DEPT <br /> Location 16502 SCHULTE RD <br /> TRACY, CA 953779700 <br /> Phone 209-832-0153 <br /> Mailing Address 432 E 11TH ST <br /> TRACY, CA 95376 <br /> Care of CITY OF TRACY <br /> Location Code 99- UNINCORPORATED P Aft Phone <br /> BOS District 005 - ORNELLAS, LEROY Fax <br /> APN 20911039 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 AR0033917 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility 1 Account <br /> Account Name TRACY FIRE DEPT (Circle One) <br /> Account Balance as of 8/2012008: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Pr !Element and Description Record ID Employee ID and Name Status New Omen Delete <br /> 2800 ABOVEGROUND STORAGE TANK(AST)PRPRO528153 EE0000001 -LINDA TURKATTE Inactive Y N A I D <br /> Gand COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andlor project specific,PHSlEHD hourly charges associated with this <br /> fa 'lity or activity will be billed to the pa identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinace Codes and/or Standards and <br /> St to andlor Federal Laws. <br /> 28W� <br /> APPLICANT'S SIGNATURE: Date ! 1 <br /> Program Records to be TRANSFERED: *$20.00= Amount Paid Date I I <br /> Water System to be TRANSFERED: *$372.00= Amount Paid D t ../ ! <br /> Payment Type Check Number Receiv <br /> REHS: Date _l��l a Account out: Dale <br /> COMMENTS: <br /> 11phs-ehsql-ntlappslenvisionslreports15021.rpt / <br /> I <br />