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PLO by =ANO` Joaquin County PHS/EHD Report #5021 <br /> FA.CII INFORMATION a7 of 01. /07/4 <br /> Make changeslcorrections in RED pen or pencil: <br /> OWNER FILE INFORMATION INFORMATION CHANGE (date): <br /> OLINERSHIP CHANCE (date): <br /> OWNER 10: 000915 � � Neu Owner ID: -to �I <br /> Owner Name: A t z tj S i ,: � <br /> Owner OBA: ATF-�-A-,-tc- <br /> Owner Address: ,e}� u <br /> MANTECA , CA 95336 <br /> Home Phone: 209-239-4444 <br /> Soc Sect J Tar. ID;: <br /> Ownership Type: 01 CORPORA T I O N l <br /> Mailing Address: tie- -3?,�' �Fv�(� �( i �� � �Y, <br /> Care of: AbP11A-FES. z, r-- <br /> MANTECA , CA 95336 <br /> FACILITY FILE INFORMATION <br /> FACILITY me: ©0- 11 � 3a _���� <br /> Facility Game: a' ouaT F�' <br /> Location: 400 INDUSTRIAL PARK: DR <br /> h1ANTE CA 95336 �,,. ^ � � <br /> Phone: 209-239-4444 <br /> Mailing Address: P-fA-L, DY <br /> Care of: n-i-o i LLC <br /> MANTECA , CA 95336 <br /> location Code: 04 APN: <br /> BOS District: 0 0 5 SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT I0: 0001180 New Account I0: 000 <br /> Mail Invoices to: Facility Mail Invoices to: Owner / Facility / Accourit <br /> Account Name: ALPHATEC (Circle one) <br /> Account Balance as of 01/07/98 : tisr . 90 (Circle one) <br /> Record UST(s) Transfer to Activate J Inactivate <br /> PJE Description ID Employee Status Linked new owner? Delete <br /> -- _-.------_------_-,---------------------------._._ <br /> 2227 GEN 51,25 TONS PERMIT PR22OO18 3973 MCCLELLON ACTIVE Y N A I D <br /> 2399 UNIFIED PROGRAM FAC STATE SERV PR5O1270 3973 MCCLELLON ACTIVE De10f, Y N A I D <br /> ...--------------------------------------------------------------------------- <br /> BILLING and COMPLIANCE ACKNOWLEOGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site and/or <br /> project specific PHSJEHO hourly charges associated with this facility or activity will be billed to the party identified as the <br /> BILLING PARTY on this form. I also certify that all operations will be performed Sn accordance with all applicable SAN JOAQUIN <br /> COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> - --—---- ------ -- --——------_ _-—------ ---- <br /> OR Records to be TRANSFERED: x 20.60 Amount Paid Date_/ r- <br /> Water System to be TRANSFERED: r. ,150.00 - Amount Paid Date—/—/_ <br /> Payment Type Check 0 Reevd by <br /> RENS or COUNTER SURV Date_f_/_ ACCT out: Date/ / UNITJFiie: r <br /> • _ <br /> pof �"(� W 11"1� �i II tri ce - C,�rnsu l-ktu�t ��p�,► l i�i2s <br /> C e-/ oP Name Uccu.rved-, I rJ Da. 1 oaj -- <br />