Laserfiche WebLink
Rill „ 12/23/2016 9:01:41A SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Repo Rsort <br /> Run by <br /> Facility Information as of 12/23/2016 Papel <br /> Record Selection Criteria: Facility ID FA0022136 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) S2- 1--c 1 \\ <br /> OWNER FILE INFORMATION Number of facilities for this owner: 32 <br /> SSN/Fed Tax ID <br /> Owner ID OW0009900 New Owner ID <br /> Owner Name AMERICAN TOWERS -EH&S Dept. <br /> Owner DBA AMERICAN TOWER <br /> OwnerAddress 10 PRESIDENTIAL WAY <br /> WOBURN, MA 01801 <br /> Home Phone 602-284-0280 <br /> Work/Business Phone 602-999-5139 <br /> Mailing Address 10 Presidential Way <br /> Woburn, MA 01801 <br /> Care of SCOTT SANDEFUR <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0022136 10406224 <br /> Facility Name AMERICAN TOWERS MANTECA NORTH #1( <br /> Location 10988 E SOUTHLAND RD <br /> MANTECA, CA 95336 <br /> Phone 602-284-0280 <br /> Mailing Address PO BOX 63604 <br /> PHOENIX,AZ 85082 <br /> Care of <br /> Location Code 99-UNINCORPORATED A Alt Phone <br /> BOIS District 003-BESTOLARI DES, STEVE Fax <br /> APN 20807010 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0040356 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name AMERICAN TOWERS MANTECA NORTH #1008 (Circle One) <br /> Account Balance as of 12/23/2016: $0.00 <br /> (Circle One) <br /> Transferto Activednaclve <br /> Program/Element and Description Record ID Employee ID and Name Status Neu nwman �elete <br /> 1926-HMBP-Remote Network Location PR0538292 EE0000009-NICHOLAS LOEHRER Active,l Y N A (I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT. I,the undersigned owner,operator or agent of same,acknowledge that all site,andor project specRio PHSIEHD hourly charges associated with this <br /> facility or activity will be billed to the party identified as the OWNER on this fano. I also certify that all operations will be performed in accordance with all applicable Ordinance Codes eri Standards <br /> and State and'or Federal Lewis <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: •$25.00= Amount Paid Date / / <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type Check Number Received by <br /> EHD Staff. Date 2— Account out: _ Date / .23 <br /> COMMENTS: <br /> Invoice#: <br />