Laserfiche WebLink
Date run 1/14/2011 4:07:56PA SAN JOIN COUNTY,,VYVIRONMENTAL HEAL DEPARTMENT <br /> Report 45021 <br /> Run by Pagel <br /> Facility Information as of 1/14/20 <br /> Record Selection Criteria: Facllity ID FA0012555 <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 OW0009755 New Owner ID <br /> Owner Name OATtS—, AfRYIN L <br /> Owner DBA RISE <br /> Owner Address al&4.��RD <br /> 5828 <br /> Home Phone gTe-38 f3600 <br /> Work/Business Phone Not Specified <br /> Mailing Address RD <br /> 828 <br /> Care of SES <br /> FACILITY FILE INFORMATION a. <br /> Facility ID FA0012555 <br /> Facility Name BUZZ OATES ENTERPRISE <br /> Location 1501 S AIRPORT WAY <br /> STOCKTON, CA 95206 <br /> Phone <br /> Mailing Address g61 R Fly �D <br /> g 828 <br /> Care of MAfkytIJ-0ATES <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOB District 001 -VILLAPUDUA Fax <br /> APN 16902011 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name MARVIN OATES <br /> Title <br /> Day Phone 916-381-3600 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0020662 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name LQ0 ^TATS (Circle One) <br /> Account Balance as of 1/14/2011: $0.00 <br /> (Circe One) <br /> Transfer to Active/Inadw <br /> ProgramfElemenl and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2950-ENVIRON ASSESS PR0516318 EE0000997-HARLIN KNOLL 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 Ordinace Codes and/or Standards and <br /> State andtor Federal Laws. <br /> APPLICANTS SIGNATURE: S 2 e �F 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 y <br /> REHS: Date_/ / Account out: Date <br /> COMMENTS: <br /> J <br /> \\eh-env\envision\reports\5021.rpt <br />