Laserfiche WebLink
Date run 6!3012004 9.09:20AA SAN H UIN COUNTY ENVIRONMENTAL HEA I DEPARTMENT <br />Run by Facility Information as of 613012004 <br />Record Selection CriteriaFacility ID FAD014655 <br />OWNER FILE INFORMATION <br />Owner ID <br />OW 0011666 <br />Owner Name <br />TRACY DISPOSAL SERVICE <br />Owner DBA <br />Owner Address <br />PO BOX 274 <br />TRACY, CA 95376 <br />Home Phone <br />Not Specified <br />Work/Business Phone <br />Not Specified <br />Mailing Address PO BOX 274 <br />TRACY, CA 95376 <br />Care of TRACY DISPOSAL SERVICE <br />FACILITY FILE INFORMATION <br />Facility ID FA0014655 <br />Facility Name TRACY DISPOSAL SERVICE <br />Location PO BOX 274 <br />TRACY, CA 95376 <br />Phone <br />Mailing Address PO BOX. 274 <br />TRACY, CA 95376 <br />Care of TRACY DISPOSAL SERVICE <br />Location Code <br />BOS District <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0024924 <br />Mail Invoices to Facility <br />Account Name TRACY DISPOSAL SERVICE <br />Account Balance as of 613012004: $0.00 <br />Make changeslcorrections in REq ink or pencil. <br />INFORMATION CHA ) <br />OWNERSHIP CHA 4, " Ir <br />New Owner ID : <br />APN: <br />SIC Code: <br />Report 05621 <br />Paget <br />New Account I D: : <br />Mail Invoices to: Owner ! Facility 1 Account <br />(Circle One) <br />(Circle One) <br />Transfer to Activellnactve <br />ProgramlElement and Description Record ID Employee ID and Name Status New Owner? Delete <br />2217 -APPLIANCE RECYCLER PRO521575 EE0008389 - DENNIS CATANYAG Active Y N A 3 D <br />BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site, and/or project specific, PHSIEHD 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 Ordinace Codes andfor Standards and <br />State andlor Federal Laws. <br />APPLICANT'S SIGNATURE: <br />Program Records to be TRANSFERED: <br />Water System to be TRANSFERED: <br />Payment Type Check Number <br />REHS: t��c`•., <br />COMMENTS <br />11Phs-ehsgl-ntlapps\Envisions\Reports15021.rpt <br />Date I I <br />` $20.00 = Amount Paid Date / ! <br />$155.00 = Amount Paid Date 1 1 <br />Received by <br />Date DkA /,V% /QA Account out: :4,L Date I <br />oq <br />