Laserfiche WebLink
Datemn 3/13/2008 3:43:51PR SAN J0#UIN COUNTY ENVIRONMENTAL HEA&DEPARTMENT Report#5021 <br /> Runfby 1006 .. Pagel <br /> Facility Information as of 3113/2678v <br /> Record selection Criteria: ality ID FA0014919 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION aL <br /> Owner ID OW0011926 New Owner ID <br /> Owner Name JACOBS, FELIX <br /> Owner DBA JAUREGUI BODY SHOP <br /> Owner Address 43 CONNIE CT <br /> BAY POINT, CA 945651576 <br /> Home Phone 925-864-9094 <br /> Work/Business Phone 209-470-0864 <br /> Mailing Address 43 CONNIE CT <br /> BAY POINT, CA 945651576 <br /> Care of FELIX JACOBS <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0014919 <br /> Facility Name JAUREGUI BODY SHOP <br /> Location 819 E FREMONT ST <br /> STOCKTON, CA 95202 <br /> Phone 209-470-0864 <br /> Mailing Address 819 E FREMONT ST <br /> STOCKTON, CA 95202 <br /> Care of FELIX JACOBS <br /> Location Code 'PN: <br /> BOIS District SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0025455 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name JACOBS, FELIX (Circle One) <br /> Account Balance as of 3/13/2008: $237.00 <br /> (Circe One) <br /> Transfer to ggive/Inactve <br /> New OwmeR tele <br /> Program/Element and Description Record ID Employee ID and Name Status <br /> 2220-SM HW GEN<5 TONS/YR PRO521940 EE6666666-Toua Alias-Yang Active Y N I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPR0516005 EE0000000-HAZ MAT SJC IDES Inactive Y N I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARPR0516006 EE0009999-SITE UNASSIGNED Inactive Y N D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andlor project specific,PHS/EHD hourly charges assilbated with this <br /> facility 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 Ordinace Codes and/or tandards and <br /> State andlor Federal Laws. �^I .//A.imT p <br /> APPLICANT'S SIGNATURE: 56. A ! (/v9b Date / / 1 <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date (� , <br /> Water System to be TRANSFERED: _*$372.00= Amount Paid Date / I <br /> Payment Type — Check Number Received by <br /> RENS: `.-/SDate / / Account out: Date_.�/1_/DF_i <br /> COMMENTS: <br /> S � <br /> \\phs-ehsql-nt\apps\envisions\reports\5021.rpt <br />