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BILLING_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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7835
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2200 - Hazardous Waste Program
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PR0539766
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BILLING_PRE 2019
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Entry Properties
Last modified
12/5/2018 11:46:55 AM
Creation date
11/1/2018 8:51:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
BILLING_PRE 2019
FileName_PostFix
PRE 2019
RECORD_ID
PR0539766
PE
2220
FACILITY_ID
FA0022750
FACILITY_NAME
Luccadeira Farms
STREET_NUMBER
7835
Direction
S
STREET_NAME
INLAND
STREET_TYPE
Dr
City
Stockton
Zip
95206
APN
131-300-01
CURRENT_STATUS
01
SITE_LOCATION
7835 S Inland Dr
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\I\INLAND\7835\PR0539766\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
7/24/2017 11:33:49 PM
QuestysRecordID
3527736
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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LDaterun 1/1512015 4:03:34PR SAN JO,. AN 1COUNTY ENVIRONMENTAL HEAL T DEPARTMENT Report#5021 <br /> Pagel <br /> yFacility Information as of 111512015 <br /> rd Selection Criteria, Facility ID FACO22750 _ <br /> Make changeslcorrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 1 SSN 1 Fed Tax ID <br /> Owner ID OW0020547 New Owner ID <br /> Owner Name Richard Marcucci <br /> Owner DBA <br /> Owner Address <br /> Home Phone Not Specified <br /> Work/Business Phone 209-481-3641 <br /> Mailing Address PO BOX 5 <br /> Holt, CA 95234 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID 1 CERS ID FA0022.750 10484737 <br /> Facitity Name Luccadeira Farms <br /> Location 7835 S Inland Dr <br /> Stockton, CA 95206 <br /> Phone 209-481-3641 x <br /> Mailing Address PO BOX 5 <br /> Halt, CA 95234 <br /> Care of Richard Marcucci <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN 131-300-01 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0041691 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility 1 Account <br /> Account Name Richard Marcucci (Circle One) <br /> Account Balance as of 111512015: $0.00 <br /> (Circle One) <br /> Transfer to Activellnactve <br /> ProgramlElement and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1958-HM-Farm Operations PRO539767 FE0009817-ROBERT LOPEZ Active Y N A I D <br /> 2220-SM HW GEN<5 TONSIYR PRO539766 EE0005642-MICHELLE HENRY Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENTI,the undersigned owner,operator or agent of same,acknowledge that all site,andfor project specific,PHS/EHD hourly charges associated withthis 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 ancl'or Standards and State ancVcr <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: Date f ! <br /> Program Records to be TRANSFERED: W$25.00= Amount Paid Date 1 1 <br /> Water System to be TRANSFERED: Amount Paid Date-/-/ <br /> Payment Type Check Number Received b <br /> REHS: k kiiiJ Date _L I Account out: Date <br /> COMMENTS. <br /> FACA t,At'rlj lli C-6 <br />
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