Laserfiche WebLink
Date run 2/10/2016 10:50:42AI ,SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 2/10/2016 <br /> Record Selection CriteriaFacility ID FA0004824 <br /> Make changes/corrections in RED ink. //.. <br /> INFORMATION CHANGE(date) !ice l—lf Cj <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 1 SSN/Fed Tax ID <br /> Owner ID OW0003726 New Owner ID <br /> Owner Name BARBAGELATA, JOHN S <br /> Owner DBA BARBAGELATA ORCHARDS <br /> Owner Address 18365 E BAKER LN <br /> LINDEN, CA 95236 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-887-3509 <br /> Mailing Address 18365 E BAKER <br /> LINDEN, CA 95236 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID I CERS ID FA0004824 10181689 <br /> Facility Name BARBAGELATA ORCHARDS <br /> Location 18365 E BAKER LN <br /> LINDEN, CA 95236 <br /> Phone 209-887-3509 x0 <br /> Mailing Address 18365 E BAKER <br /> LINDEN, CA 95236 <br /> Care of John S. Barbagelata <br /> Location Code 99 - UNINCORPORATED A Alt Phone <br /> BOS District 004 - WINN, CHARLES Fax <br /> APN 09124053 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0005258 New Account ID <br /> Mail Invoices to Account Mail Invoices to: Owner 1 Facility I Account <br /> Account Name BARBAGELATA ORCF DS (Circle one) <br /> Account Balance as of 2/10/2016 6.00 <br /> '� l0ircle One? <br /> v Transfer to Activeilnachre <br /> ProgramlElement and Description Record ID Employee Ip and Name Status New Owner? Delete <br /> 1958-HM-Farm Operations PR0525953 EE0002670-MUNIAPPA NAIDU Active Y N A I D <br /> C727Q---f,M HW GEN t5 TONSIYR PRO539865 EEOO00027-CINDY VO Active Y N A I D <br /> EXCLUDED UST FACILITY PR0500604 EE0000451 -STEVE SASSON Inactive Y N A I D <br /> 2840-AST EXEMPT FAC < 1,320 GAL PRO529018 EE0009488-JEFFREY WONG Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0532201 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT' I,the undersigned owner,operator or agent of same,acknowledge that all site,andror project specific,PHSIFHD hourly charges associated with this facility or <br /> 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 Ordinance Codes and+or Standards and State andlcr Federal Laws. <br /> APPLICANT'S SIGNATURE: Date 1 <br /> Program Records to be TRANSFERED: $25.00= Amount Paid Date ii� I <br /> Water System to be TRANSFERED: Amount Paid Date ! I <br /> Payment Type Check Number Receivedy <br /> EHD Staff Date��1 /O l�r� Account out: Date l 4- f <br /> COMMENTS <br />