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Date run : 7/18/00 12:44:46PM SAN AQUIN COUNTY PUBLIC HEALTH SEK-,ZES Report #: 0002 <br /> Run by LBROWN �-' Facility Information as of 7/18/00 Page #: 1 <br /> Record Selection Criteria: Facility ID FA0009677 <br /> Record ID <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE (date) <br /> OWNERSHIP CHANGE (date) <br /> OWNER FILE INFORMATION <br /> Owner ID: OW0007677 Case Number: H05108 New Owner to <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 to: FA0009677 <br /> Facility Name: PG&E LODI SUBSTATION d'm✓O Qi 'daa0 1 �� <br /> Location: 223 N CHEROKEE LN <br /> LODI, CA 95240 20 � n yh L <br /> Phone: 209-843-5013 r V l e>✓ <br /> Mailing Address: PO BOX 671 <br /> Care of: PG&E/CLIFF SEVERSON <br /> Location Code: 02 -LODI APN; 043-202-10 <br /> BOS District: 004-SEIGLOCK, JACK SIC Code; <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID: AR0016677 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 /> UST(s) Transfer to Active/Inacty <br /> Program/Element and Description Record ID Employee ID and Name Status Linked New Owner? Delete <br /> 2226-CaIARP PROGRAM PR0514634 EE0000000-SJC OES Active Y N 1 <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE F PR0509677 EE0000000-SJC OES Active Y N <br /> 2220-SM HW GEN<5 TONS/YR PR0513969 EE0006213-PEDRAZA Active Y N <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PR0511965 EE0000000-SJC OES Active Y N I <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of'same,acknowledgge that all site,anWorproject <br /> speelfu;PMSIERD hourly charges associated with this facility or activity will be billed to the party uleMm red as the B/LL/NG PARTY on thisform / <br /> also cert that all operations wig be performed in accordance with all applicable Ordinate Codes an or Standards and State and/or Federal Laws <br /> APPLICANT'S SIGNATURE: Date I I <br /> Program Records to be TRANSFERED: '$0.00= Amount Paid Date / / <br /> Water System to be TRANSFERED: `$150.00= Amount Paid Date / /_ <br /> Payment Type Check Number Receipt Number Received by <br /> REHS: Date I / Account out: Date /J-L–/a�— <br /> 1.0.0.89.00 <br />