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Dale run 1/212003 12:16:44PM SAN J6` JUIN COUNTY ENVIRONMENTAL HE Report�t <br /> Runty i A�ti DEPARTMENT <br /> - Facility Information as of 1/2/2003 F�e1 <br /> Record selection Criteria: Facility ID FA0011033 <br /> Make changes/corrections in RED Ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0009033 Case Number: H09191 New Owner ID <br /> Owner Name STOCKTON INTERTRANS CORP <br /> Owner DBA <br /> Owner Address <br /> Home Phone Not Specified <br /> Work/Business Phone 209-462-8700 <br /> Mailing Address 5000 S AIRPORT WAY <br /> STOCKTON, CA 95206 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> FacilityID FA0011033 <br /> Facility Name YELLOW CAB CO VVV <br /> Locab ✓A 1 851 S C E DIXON ST _jV,, 0 98 3 <br /> TOCKTON, CA 95206 RV T <br /> Phone 209-462-8700 7030 S �' Y! }[ 6YV <br /> Mailing Address 5000 S AIRPORT WAY <br /> STOCKTON, CA 95206 <br /> Care of STOCKTON INTERTRANS CORP <br /> Location Code 01 -STOCKTON APN:177-260-25 <br /> BOS District 001 -GUTIERREZ, STEVE SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0018033 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name YELLOW CAB COMPANY (circle OAe) <br /> Account Balance as of 1/2/2003: $0.00 <br /> (Circle Ore) <br /> Transfer to Active/Ireclve <br /> Program/Element and Description Record ID Employee 10 and Name Status New Owren Delete <br /> Q. PRO514501 EE0000000-HAZ MAT SJC DES Active Y ND <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PR0513321 EE0000o00-HAZ MAT SJC DES Active Y N A D <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE FPR0511033 EE0000000-HAZ MAT SJC DES Active Y N A D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site.and/or project specific,PHS/EHO hourly charges assccla weh Ihb <br /> facrsy or aclivgy 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 /> Slate and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Dale I / <br /> Program Records to be TRANSFERED: •$20.00= Amount Paid Date / / <br /> Water System to be TRANSFERED: •$155.00= Amount Paid Date / ! <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: L45 Date 0 / 031D'> <br /> COMMENTS: <br /> OD igd-g Z <br /> PK057g0'q f ( Amr�� <br /> a�y� Q2 s7 0 9S <br /> Phs-ehsgl-nt\apps\Envisions\Reports\5021.rpt <br />