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Date run : 7/18/00 12:28:38PM SANOAQUIN COUNTY PUBLIC HEALTH SER ES Report #: 0002 <br /> Run by tBROWA Facility Information as of 7/18/00 Page #: 1 <br /> Record Selection Criteria: Facility ID FA0009668-FA00009682 <br /> Record ID <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CH date) <br /> OWNERSHIP CHA <br /> OWNER FILE INFORMATION <br /> Owner ID; OW0007668 Case Number: H05097 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: FA0009668 <br /> Facility Name: PG&E FRENCH CAMP SUBSTATION <br /> Location: 554 MATHEWS RD <br /> FRENCH CAMP, CA 95231 20 <br /> Phone; 209-843-5013 <br /> Mailing Address: PO BOX 671 <br /> Care of: PG&E/CLIFFSEVERSON <br /> Location Code: 99- UNINCORPORATED AREA APN; 193-180-84 <br /> Bos District: 001 -GUTIERREZ, STEVE SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID: AR0016668 New Account ID:: <br /> Mail Invoices to: Account Mail Invoices to: Owner/Facility/Account <br /> Account Name: PG&E (Circle One) <br /> Account Balance as of 7/18/00: $100.00 <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-CaIARP PROGRAM PRO514628 EE0000000-SJC OES Active Y N i <br /> 2220-SM HW GEN<5 TONSNR PRO513960 EE0007289-YOUNGBLOOD Active Y N <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE F PRO509668 EE0000000-SJC OES Active Y N 1 <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PR0511956 EE0000000-SJC OES Active Y N I <br /> BILLING and COMPLIANCE A CKNOWLEDGEMENT.• I,the undersigned owner,operator or agent gf-same,acknowledge that all site,and/orproject <br /> specific,PHSIEHD hourly charges associated with this facility or activity will be billed to the party identr ted as the BILLING PAR7Yon thisfortn <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 /> APPLICANT'S SIGNATURE: Date / / <br /> Program Records to be TRANSFERED: '$0.00= Amount Paid Date <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 49-71 / OU <br /> 1.0.0.89.00 <br />