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Date run 11/7/2002 9:27:46Ah SAN JOAOUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> a� Facility Information as of 11 17/2G,.*. <br /> Record Selection Criteria: Facility ID FA0010919 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0008919 Case Number: H08974 New Owner ID <br /> Owner Name LAIDLAW TRANSIT SVC <br /> Owner DBA LAIDLAW TRANSIT <br /> Owner Address <br /> Home Phone Not Specified <br /> Work/Business Phone Q09-982-451-4 <br /> Mailing Address pe-81DJC26-- <br /> -eii <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010919 <br /> Facility Name LAIDLAW TRANSIT <br /> Location 500 W DELIVERY DR <br /> FRENCH CAMP, CA 952310020 <br /> Phone 209-982-4514 <br /> Mailing Address pg-BEW 26 e—F)"M'A Ilk e5r. <br /> ��ceuv�'>, . LtT)a 9� -or 6'P <br /> Care of LAIDLAW TRANSIT <br /> Location Code 99 - UNINCORPORATED AREA APN:193-050-03 <br /> BOS District 001 -GUTIERREZ, STEVE SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account lD AR0017919 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name LAIDLAW TRANSIT SVC (Circle One) <br /> Account Balance as of 11/7/2002: $0.00 <br /> (Circle One) <br /> Transfer to Actwe/InaMe <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2220-SM HW GEN<5 TONS/YR PRO514451 EE0007289-ALISON YOUNGBLOOD Inactive Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PRO513207 EE0000000-HAZ MAT SJC IDES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE FPR0510919 EEo000000-HAZ MAT SJC OES Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknoMedge that all site,and/or project speck,PHS/EHD hourly charges associated with this <br /> facility or activity will be billed to the party identified as the OWNER on this faun. I also certify that all operations will be performed in accordance with all applicable Ordinace Codes and/or Standards and <br /> State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: "$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: "$155.00= Amount Paid ate / / <br /> Payment Type Check Number by <br /> RENS: Date / / Account out: / to <br /> COMMENTS: — I �� �Y/V C�l��/��¢C��� - - �4��V'i✓'-� ✓ , <br /> \\Phs-ehsql-nt\apps\E n vis ions\Reports\5021.rpt <br />