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Date run :07/18/00 12:45:47PM SAN %QUIN COUNTY PUBLIC HEALTH SER,..OtES Report #: 0002 <br /> Run F by LBROWN Facility Information as of 7/18/00 Page #: 1 <br /> Record Selection Criteria: Facility ID FA0009682 <br /> Record ID <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE (date) <br /> OWNER FILE INFORMATION OWNERSHIP CHANGE (date) <br /> owner 1D: OW0007682 Case Number H05114 New Owner ID <br /> Owner Name; PG&E <br /> Owner DBA: <br /> Owner Address- <br /> Home Phone; Not Specified <br /> Work/Bussness Phone: 415-973-7000 <br /> Mailing Address: PO BOX 770000 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID: FA0009682 I <br /> Facility Name: PG&E MIDDLE RIVER SUBSTATION <br /> Location: 17477 W BACON ISLAND RD <br /> STOC CA 95205 20 /i ,/ Sr Phone: 209-843-5013-501 3 fits <br /> Mailing Address: PO BOX 671 <br /> Care of: PG&E/CLIFFSEVERSON <br /> Location Code: APN; 129-200-03 <br /> BOS District: SIC Code; <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID: AR0016682 New Account ID:: <br /> Mail Invoices to: Account Mail Invoices to: Owner/ Facility/Account <br /> Account Name: PG&E (Circle One) <br /> Account Balance as of 7/18/00: $100.00 <br /> (Circle One) <br /> Pro ram/Element and Description UST(s) Transfer to Active/Inacty <br /> 9Record ID Employee ID and Name Status Linked New Owner? Delete <br /> 2226-CatARP PROGRAM PRO514638 EE0000000-SJC DES Active Y N <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE F PRO609682 EE0000000-SJC OES Active Y N <br /> 2220-SM HW GEN<5 TONS/YR PR0513974 EE0000418-KITH Active Y N <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PRO511970 EE0000000-SJC DES Active Y N I <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT.• I,the undersigned owner,operator or agent oOame,acknowledge that a6 site,and/orpro'ect <br /> specific,PHS/EHD hourly charges associated with this facility or activity will be baled to the party rdelat(r'ed as the BILLING PARTY on this form. <br /> also certify,that all operations will be performed in accordance with all applicable Ordinace Codes and/or Standards and State and/or Federal Laws <br /> APPLICANT'S SIGNATURE: Date I / <br /> Program Records to be TRANSFEREU '$0.00= Amount Paid Date <br /> Water System to be TRANSFERED: '$150.00= Amount Paid Date <br /> Payment Type Check Number Receipt Number Received iby <br /> REHS: Date /_/_ Account out: Date <br /> 1.0.0.89.00 <br />