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Date run : 11/20/00 9:03:01AM SA*AQUIN COUNTY PUBLIC HEALTH SEES Report #: 0002 <br /> Run by DWILSON Facility Information as of 11/20/00 Page #: 1 <br /> Record Selection Criteria: FacilityID FA0003881 -3881 <br /> RecordlD <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE (date) <br /> OWNERSHIP CHANGE (date) <br /> OWNER FILE INFORMATION <br /> Owner ID: OW0002869 New Owner ID <br /> Owner Name: GENERAL MILLS OPERATIONS, INC <br /> Owner DBA; GENERAL MILLS <br /> Owner Address: 9200 WAYZATA BLVD <br /> MINNEAPOLIS, MN 55246- <br /> Home Phone: 209-369-3541 <br /> Work/Bussness Phone: 209-369-3541 <br /> Mailing Address: PO BOX 3002 <br /> LODI, CA 55246- <br /> care of: GENERAL MILLS OPERATIONS, INC <br /> FACILITY FILE INFORMATION <br /> Facility ID: FA0003881 <br /> Facility Name: GENERAL MILLS <br /> Location: 2000 W TURNER RD <br /> LODI, CA 95240 <br /> Phone: 209-369-3541 <br /> Mailing Address: CALL BOX 3002 <br /> LODI, CA 95241-1906 <br /> Care of: TECHNICAL SERVICES MGR <br /> Location Code: 02 - LODI APN: <br /> BOS District: 004- SEIGLOCK, JACK SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID: AR0003469 New Account ID:: <br /> Mail Invoices to: Facility Mail Invoices to: Owner/Facility/Account <br /> Account Name: GENERAL MILLS (Circle One) <br /> Account Balance as of 11/20/00: $0.00 <br /> (Circle One) <br /> UST(s) Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status Linked New Owner? Delete <br /> 2226-CaIARP PROGRAM PR0514607 EE0000000-SJC DES Active Y N A I D <br /> 2381 -UST FACILITY(BEFORE 1/84) PR0231381 EE0006213-PEDRAZA Active 6 Y N A01D <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE FI PR0507513 EE0006213-PEDRAZA Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511808 EE0000000-SJC OES Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or <br /> project specific,PHS/EHD hourly charges associated with this facility or activity will be billed to the party identified as the BILLING PARTY on this <br /> form. 1 also certify that a0 operations will be performed in accordance with all applicable Ordieace Codes and/or Standards and State and/or Federal <br /> 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 <br /> 1.0.0.89.00 <br />