Laserfiche WebLink
Date nm 3/10/2016 9:15:58Ak SAN JOAMN COUNTY ENVIRONMENTAL HEAL*EPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 3/10/2016 <br /> Record Selection Criteria: Facility ID FA0017043 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 1 SSN/Fed Tax ID <br /> Owner ID OW0013884 New Owner ID <br /> Owner Name SAS FARMS <br /> Owner DBA SAS FARMS <br /> OwnerAddress 16501 TRACY BLVD <br /> TRACY, CA 95304 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-481-5160 <br /> Mailing Address 16501 S TRACY BLVD <br /> TRACY, CA 95304 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility lD/CERS ID FA0017043 10185801 <br /> Facility Name SAS FARMS <br /> Location 12434 S CAL PACK RD <br /> STOCKTON, CA 95206 <br /> Phone 209-481-5160 x <br /> Mailing Address 16501 S TRACY BLVD <br /> TRACY, CA 95304 <br /> Care of Vernon Arnaudo <br /> Location Code 99-UNINCORPORATED P Alt Phone <br /> BOS District 005-ELLIOTT, BOB Fax <br /> APN 18925023 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 AR0029925 New AcccuntlD: : <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name SAS FARMS (Circle One) <br /> Account Balance as of 3/10/2016: $266.00 <br /> (Circle One) <br /> Transfer to Activennactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1958-HM-Farm Operations PR0525228 EE0002670-MUNIAPPA NAIDU Active Y N A 'g D <br /> 2220-SM HW GEN<5 TONSNR PR0530971 EE0001469-VICKI MCCARTNEY Active Y N A D <br /> 2830-AST FAC -SPCC EXEMPT PRO530970 EE0001 459-VICKI MCCARTNEY Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO534259 Inactive Y N A I D <br /> BILLING and COMPLANCEACKNOWLEDGEMENT: [.the undersigned owner,operator or agent of same,ac knowledge that '%and'or project specific,PHSrEHD hourly charges associated with this facility <br /> or activity will be billed to the party idanlifietl as the OWNER on this form [also ceM1ify that all operations will be anon, scour, n a with all applicable Ordinance Codes end'or Standards and State andlor <br /> Federal Laws. <br /> APPLICANTS SIGNATURE: ' Date <br /> Program Records to be TRANSFERED: *$25.00= Amount Paid Date / ! <br /> Water System to be TRANSFERED: Amount Paid Date / / <br /> Payment Type Check Number Received by <br /> EHD Staff: M Date 3 1 t O Account out: Date -3 1 / <br /> COMMENTS: A <br /> IqyOIce <br /> N tl d — F d InR �vIG1�e,�cJ W Wn: <br /> V" <br />