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Date un 3/2/2011 10:02:10AM SAN Jr\ '2UIN COUNTY ENVIRONMENTAL HES, 11 DEPARTMENT Report#5021 <br />""- <br />Run by Pagel <br />Facility Information as of 3/2/2011 <br />Cdtena: Facility ID <br />OWNER FILE INFORMATION <br />Owner ID <br />OW0000781 <br />Owner Name <br />ST JOSEPHS MEDICAL CENTER <br />Owner DBA <br />Owner Address <br />1800 N CALIFORNIA <br />STOCKTON, CA 95204 <br />Home Phone <br />209-956-3400 <br />Work/Business Phone <br />Not Specified <br />Mailing Address <br />PO BOX 213008 <br />New 0vmr4 <br />STOCKTON, CA 952139008 <br />Care of <br />FACILITIES DEPARTMENT <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0003761 <br />Facility Name <br />ST JOSEPHS HOSPITAL <br />Location <br />1800 N CALIFORNIA ST <br />EE0000000 - HAZ MAT SJC DES Inactive <br />STOCKTON, CA 95204 <br />Phone <br />209-943-2000 <br />Mailing Address <br />PO BOX 213008 <br />PR0514656 <br />STOCKTON, CA 952139008 <br />Care of <br />MCALISTER, RAY <br />Location Code <br />01-STOCKTON <br />BOS District <br />002 - RUHSTALLER, LARRY <br />APN <br />12718044 <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name <br />Title <br />Day Phone <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0003340 <br />Mail invoices to Facility <br />Account Name ST JOSEPHS HOSPITAL <br />Account Balance as of 3/2/2011: $3,516.00 <br />Make changes/corrections in RED ink. <br />INFORMATION CHANGE (date) <br />OWNERSHIP CHANGE (date) <br />SSN / Fed Tax ID <br />New Owner 10 : <br />Alt Phone <br />Fax <br />EMail : <br />New Account ID: : <br />Mail Invoices to: Owner / Facility / Account <br />(Cirde One) <br />circle One) <br />Transfer to <br />Acsvellrectve <br />Program/Element and Description <br />Record 10 <br />Employee 10 and Name Status <br />New 0vmr4 <br />Delete <br />1626-RESTAURANT/BAR 101+ SEATS <br />PRO160504 <br />EE0001084-STEPHANIE RAMIREZ Active <br />Y <br />N <br />A <br />I D <br />2224 - HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512004 <br />EE0000000 - HAZ MAT SJC DES Inactive <br />Y <br />N <br />A <br />1 D <br />2226 - CalARP PROGRAM <br />PR0514656 <br />EE0000000 - HAZ MAT SJC DES Inactive <br />Y <br />N <br />A <br />I D <br />2244 -PACT TRANSFER RECORD - DES <br />PR0519820 <br />EE0000000-HAZ MAT SJC DES Active <br />Y <br />N <br />A <br />I D <br />2247 - RCRA GEN 5<25 TONS <br />PR0514003 <br />EE0004636 - GARRETT BACKUS Active <br />Y <br />N <br />A <br />I D <br />2301 - UST STATE SURCHARGE FEE <br />PRO515549 <br />EE0000008 - LETITIA BRIGGS Inactive <br />Y <br />N <br />A <br />I D <br />2361 - UST FACILITY <br />PR0231036 <br />EE0004636 - GARRETT BACKUS Active <br />Y <br />N <br />A <br />I D <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARFIR0507445 <br />EE0000008 - LETITIA BRIGGS Inactive <br />Y <br />N <br />A <br />I D <br />2832 - AST FAC 10 K - </-100 K GAL CUMULATIVEPRO528692 <br />EE0004636 - GARRETT BACKUS Active <br />Y <br />N <br />A <br />I D <br />2951 - UGT-CAP <br />PROO10361 <br />EE0000684 - MICHAEL INFURNA Inactive <br />Y <br />N <br />A <br />I D <br />4522 - ACUTE CARE FACILITY <br />PR0450006 <br />EE0000988 - KASEY FOLEY Active <br />Y <br />N <br />A <br />1 D <br />4557 - MED WASTE LIMITED HAULER <br />PRO522306 <br />EE0003973 - ROBERT MCCLELLON Active <br />Y <br />N <br />A <br />I D <br />ERSC - ELECTRONIC REPORTING STATE SURCHPRO532552 <br />Active <br />Y <br />N <br />A <br />I D <br />4630 - NTNC WATER SYSTEM <br />WA0461082 <br />EE0005838 - ADRIENNE ELLSAESSEActive <br />Y <br />N <br />A <br />I D <br />'7 <br />1 <br />Cir'YGC <br />7i 7i/-7 <br />`� <br />j'fo 5ab II T <br />\\eh-env\envision\reports\5021. rpt <br />