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EHD Program Facility Records by Street Name
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2200 - Hazardous Waste Program
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PR0514442
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BILLING
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Last modified
11/2/2020 10:13:14 PM
Creation date
10/31/2018 11:38:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
BILLING
RECORD_ID
PR0514442
PE
2220
FACILITY_ID
FA0010876
FACILITY_NAME
BIG FOOT TIRE REPAIR LLC
STREET_NUMBER
7200
STREET_NAME
C E DIXON
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
17726009
CURRENT_STATUS
02
SITE_LOCATION
7200 C E DIXON ST
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\C\C E DIXON\7200\PR0514442\BILLING\BILLING.PDF
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EHD - Public
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Date run 2/10/2006 8:48:23AR SAN JOA^TJIN COUNTY ENVIRONMENTAL HEALTai DEPARTMENT Report#5021 <br /> Run by 4006 �� Paget <br /> Facpjty Information as of 2/10/2001,/ <br /> Record Selection Criers Facility ID FA0010876 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0008876 Case Number: H08910 New Owner ID <br /> Owner Name NUGENERATION TECHNOLOGIES LLC <br /> Owner DBA NUGENERATION TECHNOLOGIES LLC <br /> Owner Address 100 PROFESSIONAL CENTER DR STE 101 <br /> ROHNERT PARK, CA 949282137 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-234-5930 <br /> Mailing Address 100 PROFESSIONAL CENTER DR STE 101 <br /> ROHNERT PARK, CA 949282137 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010876 <br /> Facility Name NUGENERATION TECHNOLOGIES LLC <br /> Location 7200 S CE DIXON ST <br /> STOCKTON, CA 95206 <br /> Phone 209-234-5930 <br /> Mailing Address 100 PROFESSIONAL CENTER DR STE 101 <br /> ROHNERT PARK, CA 949282137 <br /> Care of <br /> Location Code 99- UNINCORPORATED AREA /PN 17726009 <br /> BOIS District 001 -GUTIERREZ, STEVE SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0017876 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name NUGENETECHNOLOGIES LLC (Circle One) <br /> Account Balance as of 2/10/200 - $7 00 14 3` l7 <br /> (Circle one) <br /> Transfer to Active/Inaclve <br /> Pr ram/Elemem and Description Record ID Em New Owner? Delete <br /> ogEmployee ID and Name Status <br /> 2220-SM HW GEN<5 TONSNR PR0514442 EE0008389-DENNIS CATANYAG Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO513164 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2226-CaIARP PROGRAM PRO514882 EE0000000-HAZ MAT SJC OES Inactive Y N AD <br /> 2244-PACT TRANSFER RECORD-OES PR0520529 EE0000000-HAZ MAT SJC OES , clhre—� Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARlPR0510876 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all she,and/or prolect specific,PHS/EHD hourly charges associated with this <br /> faNM1y or activity vall be billed to the party identified a$the OWNER on this form. I also certHy that all operations will be performed in accordance with all applicable Ordinace Codes and/or Standards and <br /> State and/or Federal Laws. <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: '$372.00= Amount Paid Date <br /> Payment Type Check Number Received by / <br /> RENS: Date /_I_ Account out: Date <br /> COMMENTS: <br /> C L'os�� I N) �Dss Pte- �o <br /> � aLt-& _ L'Z�Asa ��r> (r- f . <br /> \\phs-ehsgl-nt\apps\envisions\repons\5021.rpt <br />
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