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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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EIGHT MILE
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11530
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2200 - Hazardous Waste Program
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PR0522380
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BILLING
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Entry Properties
Last modified
12/5/2018 10:45:15 AM
Creation date
10/31/2018 3:26:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
BILLING
RECORD_ID
PR0522380
PE
2220
FACILITY_ID
FA0003930
FACILITY_NAME
KING ISLAND MARINA
STREET_NUMBER
11530
Direction
W
STREET_NAME
EIGHT MILE
STREET_TYPE
RD
City
STOCKTON
Zip
95219
APN
07119006
CURRENT_STATUS
01
SITE_LOCATION
11530 W EIGHT MILE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\E\EIGHT MILE\11530\PR0522380\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
6/6/2017 10:06:14 PM
QuestysRecordID
3414846
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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Dai:•r 8/4/20113 9:41:30Ah <br /> Run by SAN*QUIN COUNTY ENVIRONMENTAL HEW;B DEPARTMENT <br /> Report k5021 <br /> Facility Information as of 8/19/2013 Paget <br /> Record Selection Criteria: Facility ID FA0003930 <br /> 11 NJ L lijif <br /> Make changes/corrections in RED in . <br /> INFORMATION CHANGE(date) <br /> <br /> <br /> <br /> �• r <br /> Owner DBA KING ISLANDr-enoT - <br /> Dto 1 <br /> Owner Address 14,580141 rIGk4T_MILE RD —+i—Ina- —����;.�._ yLl i^(Y4l <br /> STCKT0147GA-95209 _ <br /> Home Phone Not Specified ?+� <br /> i2a. IA A <br /> Work/Business Phone 848 6 CQ <br /> Mailing Address J4g0e-W-HWY 1-2 _ L Lf <br /> !lh '(h �2 <br /> Care of Q -Z1 <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility lD/CERS ID FA0003930 10,181,529 <br /> Facility Name KING ISLAND RESORT' 4 of I Wk <br /> Location 11530 W EIGHT MILE RD <br /> STOCKTON, CA 95219 <br /> Phone 2e"51-2188-Xp ^;hq 40-7 C- <br /> MailingAddress t4Sea-yy-H �t <br /> Low-r -9e2a2 ICQ Vt�g S act <br /> Care of <br /> Location Code 99 - UNINCORPORATED P Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> APN 07119006 EMail: gkgLt antl 49 ap ll <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> C <br /> Day Phone TA -An <br /> Night Phone PAYMENT o _ <br /> ACCOUNTS RECEIVABLE FILE INFORMATION RECE INrED <br /> Account ID AR0003535 SEp 0 5 ZU13 New Account ID: <br /> Mail Invoices to OwnerU1N COUNN Mail Invoices to: Owner / Facility / Account <br /> Account Name WESTREC INC N JOA Op)feT4TAL <br /> HEAD H pEpAA�MENT ) <br /> "a <br /> Account Balance as of 8/19/2013: $0.00 <br /> <br /> PrograMElemenl and Description Record ID Employee ID and Name Stat New Owner? Delete the <br /> 1921 -HMBP-Regular-Primary Location PR0519841 EE0006044-LOWELL ALLEN Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PRO522380 EE0004636-GARRETT BACKUS Active N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512032 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0231557 EE0000418-MICHAEL KITH Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PRO507531 EE0000418-MICHAEL KITH Inactive Y N A I D <br /> 2832-AST FAC 10 K-</=100 K GAL CUMULATIVE PR0516703 EE0004636-GARRETT BACKUS Active l�' N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0534220 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andor project spec,PHS/EHD hourly charges associated with this facility <br /> or activity will be billed to the party identified as the OWNER on this form I also certify that all operations will be performed in accordance with all applicable Ordinance Codes andor Standards and State and'ar <br /> Federal Law 33 Q <br /> Ro�PL CA�T��'ATURE: 2Z _ Date ` <br /> Program Records to be TRANSFERED: *$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid VDate _/ / 1-73 <br /> Payment Type ��-t5� Check Number Received y <br /> REHS: Date_ / l3— Account out: Date 9_/ (57/ 13 <br /> U <br /> COMMENTS: ^ r,f'� <br /> A Z 1 <br /> C <br /> 1�/t�✓� ./ <br /> r�C-1•'x,/1.•`- �✓ �l3 � J Z431�o <br />
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