BILLING - Laserfiche WebLink

Home Browse Search

Run b•' : LAURIEB &n Joaquin County PHS/EHD Report #5021 FACILITY INFORMATION as of 02/10/98 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Make changes/corrections in RED pen or pencil: OWNER FILE INFORMATION INFORMATION CHANGE (date): OWNERSHIP CHANGE (date): OWNER ID: 006357 New Owner ID: 00 owner Name: SAN JOAQUIN PACKAGING Owner DBA: SAN JOAQUIN PACKAGING owner Address: 800 W CHURCH STOCKTON, CA 95203 Home Phone: Soc Sec# / Tax ID#: ownership Type: 01 CORPORATION Mailing Address: PO BOX 160425 Care of: CLEARFIELD, UT 84016 FACILITY FILE INFORMATION FACILITY ID: 007696 Facility Nam: SAN JOAQUIN PACKAGING 1/wntiale, Location: 800 W CHURCH ST STOCKTON 95203 Phone: 209-464-3406 �• Mailing Address: PO BOX 160425 Care of: CLEARFIELD, UT 84016 Location Code: 01 APN: BOS District: 001 SIC Code: ACCOUNTS RECEIVABLE FILE INFORMATION ACCOUNT ID: 0013293 New Account ID: 000 Mail Invoices to: Facility Mail Invoices to: Owner / Facility / Account Account Name: SAN JOAQUIN PACKAGING (circle one) Account Balance as of 02/10/98 : $155 .90 (Circle e) Record UST(s) Transfer to Activate Inactivate P/E Description ID Employee Status Linked new owner? Delet _ _ _ _ _ _ - _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2227 GEN 5<25 TONS PERMIT PR507052 0418 KITH ACTIVE Y N A D 2399 UNIFIED PROGRAM FAC STATE SERV PR507053 0418 KITH ACTIVE Y N A D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1, the undersigned owner, operator or agent of same, acknowledge that all site and/or project specific PHS/END hourly charges associated with this facility or activity will be billed to the party identified as the BILLING PARTY on this form. 1 also certify that all operations will be performed in accordance with alL applicable SAN JOAQUIN COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. APPLICANT'S SIGNATURE: Date - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PR Records to be TRANSFERED: x $20.00 Amount Paid Date_/ / Water System to be TRANSFERED: x $150.00 = Amount Paid Date—/—/— Payment ate_/ /Payment Type Check # Recvd by RENS or COUNTER SUPV Date—/ /_ ACCT out: ` Date UNIT/File:_/_/_