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Date run 7/15/2008 12-49:13PI SAN JOAQUIN COUNTY ENVIRONMENTAL HEAL N DEPARTMENT Report#5021 <br />Run by Pagel <br />Facility Information as of 7/15/2008 <br />Record Selection Criteria: Facility ID FA0012350 <br />OWNER FILE INFORMATION <br />Owner ID OW0007223 Case Number: H02193 <br />Owner Name BOGETTI'S ORCHARD INC <br />Owner DBA <br />Owner Address <br />Home Phone Not Specified <br />Work/Business Phone 209-835-8972 <br />Mailing Address PO BOX 705 <br />VERNALIS, CA 95385 <br />Care of BOGETTI, ALBERT <br />FACILITY FILE INFORMATION <br />Facility ID FA0012350 <br />Facility Name BOGETTI'S" <br />Location 2523 E HWY 132 <br />VERNALIS, CA 95385 <br />Phone <br />Mailing Address PO BOX 705 <br />VERNALIS, CA 95385 <br />Care of ALBERT BOGETTI <br />Location Code 99 - UNINCORPORATED P <br />BOS District 005 - ORNELLAS, LEROY <br />APN <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name ALBERT BOGETTI <br />Title <br />Day Phone <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0020179 <br />Mail Invoices to Owner <br />Account Name BOGETTI'S ORCHARD INC <br />A\ccoun``tt" Bal s of 7/15/2008: $0.00 <br />P /Element and ance �an Des <br />Description C� �� Record ID Employee ID and Name <br />Make changes/corrections in RED ink or pencil. <br />INFORMATION CHANGE (date) <br />OWNERSHIP CHANGE (date) <br />SSN / Fed Tax ID <br />New Owner ID : <br />Alt Phone <br />Fax <br />EMail : <br />New Account ID: : <br />Mail Invoices to: Owner / Facility / Account <br />(Circle One) <br />(Circle One) <br />Transfer to Active/Inactve <br />Status New Owner? Die <br />VING <br />ASTFAC >/=100 M + 1 GAL CUMULATIVE PRO515779 EE0000001 - LINDA TURKATTE Inactive Y N A (/ I / D <br />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 Ordinace Codes and/or Standards and <br />State and/or 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: <br />COMMENTS: <br />\\ph s -e hsq I-nt\a p ps\envisions\reports\5021. rpt <br />* $20.00 = <br />* $372.00 = <br />Date <br />Date <br />Amount Paid Date <br />Amount Paid Date <br />Rece y <br />Account out: Date y/ /OS- <br />