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Date run 6/29/2011 11:09:25AI SAN JOWIN COUNTY ENVIRONMENTAL HEADEPARTMENT Report#1021 <br /> Run by 1273 Pagel <br /> Facility Information as of 8/29/2 <br /> Record Selection Cntena: Facility ID FA0015875 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0012796 New Owner ID <br /> Owner Name WADENYE <br /> Owner DBA WARD INDUSTRIES <br /> Owner Address 661 WILLOW GREEN <br /> GALT, CA 95864 <br /> Home Phone Not Specified <br /> Work/Business Phone 916-548-1347 <br /> Mailing Address 661 WILLOW GREEN <br /> GALT, CA 95864 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015875 <br /> Facility Name WARD INDUSTRIES <br /> Location 1020 E CHURCH ST <br /> STOCKTON, CA 95201 <br /> Phone 916-548-1347 <br /> Mailing Address 661 WILLOW GREEN <br /> GALT, CA 95864 <br /> Care of <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN 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 AR0027631 NewAccount ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name WADE NY (Circle One) <br /> Account Balance as of 8/29/ 827.00 /- 037g-p3 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2244-PACT TRANSFER RECORD-OES PRO523496 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project spec,PHS/EHO hourly charges associated with this <br /> facility or activity,will be billed to the party Identified as the OWNER on this form. I also cer ily that all operations will be performed in accordance with all applicable Ordinace Codes and/or Standards and <br /> Stale and/or Federal Laws. <br /> APPLICANT'S 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 /> RENS: Date / / Account out: Date <br /> COMMENTS: <br /> \\eh-env\en Asion\reports\5021.rpt <br />