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Date run 6/22/00 12:41:59PM SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report #: 0002 <br /> Run by VDAVIS Facility Information as of 6/22/00 Page #: 1 <br /> Record Selection Criteria: Facility ID FA0009703 <br /> Record to <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE (date) <br /> OWNERSHIP CHANGE (date) <br /> OWNER FILE INFORMATION <br /> Owner ID: OW0007703 Case Number: H05137 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 ID: FA0009703 �� G�✓t�T✓ a a a L� <br /> Facility Name: PG&E STAGG SUBSTATION <br /> Location: 5415 FEATHER RIVER DR <br /> STOCKTON, CA 95207 20 <br /> Phone: 209-843-5013 <br /> Mailing Address: PO BOX 671 <br /> Care of: PG&E/CLIFF SEVERSON <br /> Location Code: APN: 114-030-04 <br /> BOS District- SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID: AR0016703 New Account ID:: <br /> Mail Invoices to: Account Mail Invoices to: Owner/Facility/Account <br /> Account Name: PG&E <br /> 1 .00 - (Circle One) <br /> Account Balance as of 6/22/00: $ p�t� <br /> (Circle One) <br /> UST(s) Transfer to Active/Inacty <br /> Program/Element and Description Record ID Employee ID and Name Status Linked New Owner? Delete <br /> 2226-Ca1ARP PROGRAM PRO514653 EE0000000-SJC DES Active Y N 1 <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE F PR0509703 EE0000000-SJC OES Active Y N 1 <br /> 2220-SM HW GEN<5 TONSNR PRO513993 EE0000418-KITH Active Y N <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PRO511991 EE0000000-SJC DES Active Y N I <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: /,the undersigned owner,operator or agent of same,acknow/edge that all site,and/orpro'ect <br /> specific,PHSIEHD hourly charges associated with this facility or activity will be billed to the party identified as the BILLING PARTY on thisjarm I <br /> also certify that all operations will be performed in accordance with all applicable Ordinace Codes an or Standards and State and/or Federal Laws <br /> APPLICANTS SIGNATURE: Date / / <br /> Program Records to be TRANSFERED: "$0.00= Amount Paid Date—1-1 <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: Date 6 /Z'Z/ 60 <br /> 1.0.0.89.00 ♦ W <br />