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Rapod#. 0002 <br /> C HEALTH <br /> Flull 6/22100 12:51'.10PNI SAN JOAQ FIaN COUNT <br /> fmat og als of 6/22/00 <br /> SERVICES <br /> Page # 1 <br /> by VC4AVISrd Selection Criteria: Facility ID FA0009664 <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 to: OW0007664 Case Number: H05091 New Owner ID <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 : �� C� ✓�}�� �'aa-C7 <br /> Facility Name: <br /> PG&E: PG&E CHEROKEE SUBSTATION <br /> Location: 5505 CHEROKEE LN <br /> STOCKTON, CA 95215 20 <br /> Phone; 209-843-5013 <br /> Mailing Address: PO BOX 671 <br /> Care of: PG&E/CLIFF SEVERSON <br /> Location Code: APN; 087-122-01 <br /> BOB District: 002 - MARENCO, DARIO SIC code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID: AR0016664 New Account ID:: <br /> Mail Invoices to: Account ./ Mail Invoices to: <br /> Owner/FBCIIIty/ACCOUnY <br /> Account Name; PG&E la�T�S I (Circle One) <br /> Account Balance as of 6/22/00: $1 0 60 <br /> r <br /> (Circle One) <br /> UST(s) Transfer to Active/Inactv <br /> Program/Element and Description Record ID Employee ID and Name Status Linked New Owner? Delete <br /> 2226-CBWRP PROGRAM PRO514624 EE0000000-Sit;OES Active Y N I <br /> 2220-SM HW GEN<5 TONS/YR PR0513956 EE0000451 -SASSON Active Y N <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE F PR0509664 EE0000000-SJC OES Active Y N I <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PRO511952 EE0000000-SJC OES Active Y N I <br /> BILLING and COMPLIANCEACKNOWLEDGEMENT.• /,the undersigned owner,operator or agento/f/'''samg acknowledge that all site,nd/orpro//'eel <br /> also errf fy that all operations charges fl be performedhin accordance witor h ppl able Ordinawill be billed to lce CodesrdentiandlorStndardswilas the BILLING <br /> d State and/or Federal Laws <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be 1 $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_/_/_ Account out: V lJ Date <br /> 1.0.0.89.00 �../ <br />