Laserfiche WebLink
Dat9 run > 1/17/2010 3:59:54PN SAN JOA—UIN COUNTY ENVIRONMENTAL HEAI —"I DEPARTMENT Report#5U21Pagel <br /> Ran by 1273 LM-01FacilityInformation as of 2117120 <br /> Record Selection Criteria: Facility ID FA0016793 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID : <br /> Owner ID OW0013634 New Owner ID : <br /> Owner Name J G SANGUINETTI FAMILY LP <br /> Owner DBA <br /> Owner Address 28617 E SONORA RD <br /> FARMINGTON, CA 95230 <br /> Home Phone Not Specified <br /> Work/Business Phone Not Specified <br /> Mailing Address 28617 E SONORA RD <br /> FARMINGTON, CA 95230 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> FAOQ16793 <br /> Facility ID S ►� U-� �� �s" – <br /> Facility Name J G SANGUINETTI FAMILY LP <br /> Location 28617 E SONORA RD <br /> FARMINGTON, CA 95230 <br /> Phone 209-886-5572 x0 <br /> Mailing Address 28617 E SONORA RD <br /> FARMINGTON, CA 95230 <br /> Care of <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN 18737007 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 AR0029676 New Account ID: : <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility 1 Account <br /> Account Name i G 6 <br /> (Circle One) <br /> Account Balance as of 2117/2010: $67,00 <br /> (Circle One) <br /> Transfer to Activellnactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2223-AGRICULTURAL HAZ MAT STORAGE FACiLPRO524978 Active Y ' N A i D <br /> 2840-AST EXEMPT FAC <1,320 GAL PR0530717 EE0000753-WILLY NG Active,Exempt Y N A I D <br /> ERSC-ELECTRONIC REPORTING SURCHARGE PR0532882 Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific,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 will be performed in accordance with all applicable Ordinate Codes and/or Standards and <br /> State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date I I <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date 1 1 <br /> Water System to be TRANSFERED: "$372.00= Amount Paid Date ! / <br /> Payment Type Check Number Receiv d <br /> REHS: Date 1 1 Account out: Date 1 l� <br /> COMMENTS: 14 ' j "�) <br /> da�'o 'q wz � <br /> lleh-envlenvisionlreports15021.rpt <br />