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Date run : 3/24/00 8:53:50AM SAN kQUIN COUNTY PUBLIC HEALTH SER` ES Report #: 0002 <br /> Run by °SDRISCOL Facility Information as of 3/24/00 Page #: 1 <br /> Record Selection Criteria: FacilityID FA0010157 <br /> Record ID fk a <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE (date) <br /> OWNERSHIP CHANGE (date) <br /> OWNER FILE INFORMATION <br /> Owner to: OW0008157 Case Number: H06942 New Owner ID <br /> Owner Name; FES y U F C vsreYYC s <br /> Owner DBA: F IE7S y71g C[ /I ,f <br /> Owner Address: 3 Lf 7S 8B4ftc� lq.rpc.. <br /> o rK , j�A r 7Home Phone; No pecified <br /> Work/Bussness Phone: 717-767-6411 CT00)rX93 3 Imo Rg K <br /> Mailing Address: PO BOX 2306 <br /> Care of- <br /> FACILITY FILE INFORMATION <br /> Facility to: FA0010157 �iLC 1-Fi C- S Sf C ,y <br /> Facility Name: FES F t s Pa'c-r �r G S4 5-f <br /> Facility <br /> Location: 3210 N AD ART RD B-1 <br /> STOCKTON, CA 95215 20 <br /> Phone: 209-931-3970 <br /> Mailing Address: 3210 N AD ART RD B-1 <br /> Care of: JEROME MURRAY MGR <br /> Location Code: 99 - UNINCORPORATED AREA APN; 087-100-42 <br /> BOS District: 002 - MARENCO, DARIO SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID: AR0017157 New Account ID:: <br /> Mail Invoices to: Account Mail Invoices to: Owner/ Facility/Account <br /> Account Name: FES DIV OF THERMO POWER CORP (Circle One) <br /> Account Balance as of 3/24/00: $0.00 <br /> (Circle One) <br /> UST(s) Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status Linked New Owner? Delete <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE FE PR0510157 EE0000000-SJC OES Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512445 EE0000000-SJC OES Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR05142G4 EE0000008-BRIGGS 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 <br /> project specific,PHS/EHD hourly charges associated with this facility or activity will be billed to the party identified as the BILLING PARTY on this <br /> form. I also certify that all operations will be performed in accordance with all applicable Ordinate Codes and/or Standards and State and/or Federal <br /> Laws. <br /> APPLICANTS SIGNATURE: Date I / <br /> Program Records to be TRANSFERED: '$0.00= Amount Paid Date <br /> Water System to be TRANSFERED: '$150.00= Amount Paid Date / / <br /> Payment Tye Check Number Receipt Number Received by <br /> REHS: Date / /_6 Ac count out: Date / / <br /> 1.0.0.89.00 <br />