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Run by SANDY S�e Joaquin County PHS/EHD ./ Report #5021 <br /> FACILITY INFORMATION as- of 06/09/99 <br /> ------- - - - - - - - - - - ---------------------------------------------------------- <br /> Make changes/corrections in RED pen or pencil: <br /> Or —R FILE INFORMATION INFORMATION CHANCE (date): <br /> OWNERSHIP CHANGE (date): <br /> OWNER 1D: 008972 CASE #: H09070 New Owner ID: 00 <br /> owner Name: NANCY & DAN FRANZIA <br /> Owner DBA: <br /> owner Address: <br /> i <br /> Home Phone: <br /> Soc Sec# / Tax ID#: <br /> Ownership Type: 03 PARTNERSHIP <br /> Mailing Address: 1113 SHAW RD <br /> Care of: <br /> STOCKTON, CA 95215 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 010972 <br /> Facility Name: BIG VALLEY TRACTOR LLC <br /> Location: 3355 N AD ART RD <br /> STOCKTON 95215-2237 <br /> Phone: 37 <br /> Mailing Address: 3355 N AD ART RD <br /> care of: CHUCK IKER <br /> STOCKTON, CA 95215 (' <br /> --o <br /> Location Code: APN: 087-100-40 ��,��-�w" y <br /> BUS District: SIC Code: 5083 ryr((r���,�(�,(a�QQJ�� '1 o <br /> ACCOUNTS RECEIVABLE FILE INFORMATION `0 v -I l-I <br /> ACCOUNT ID: 0017972 New Account ID: 000 <br /> Mail Invoices to: Account Mail Invoices to: Owner Facility / Account <br /> Account Name: BIG VALLEY TRACTO (Circle one) <br /> Account Balance as of 06/09/99 : $128 . 50 (Circle one) <br /> Record UST(a) Transfer to Activate / Inactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> _______________________________________________________________________________ <br /> 2399 UNIFIED PROGRAM FAC STATE SERV 510972 0000 SJC OES ACTIVE Y N A I D <br /> 2224 HAZ MAT BUSINESS PLAN AUTHORIZ 513260 0000 SJC DES ACTIVE Y N A I D <br /> 2220 SM BW GEN <5 TONS/YR 514475 0000 SJC OES ACTIVE Y N A I D <br /> _______________________________________________________________________________ <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 <br /> BILLING PARTY on this form. I also certify that all operations will be performed in accordance with all applicable SAN JOAQUIN <br /> COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> _______________________ _ _______________________________________________ <br /> PR Records to be TRANSFERED: x $20.00 Amount Paid Date_/ / <br /> water System to be TRANSFERED: x $150.00 = Amount Paid Date-/—/— <br /> Payment <br /> ate_/ /Payment Type Check # Recvd by <br /> ___________________________ _ _______________ ____ _ _ _-_-_____ <br /> RENS or COUNTER SUPV: Date—/—/— ACCT out: Date / __ UNIT/File:_/_/_ <br /> ________ <br />