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Date An '14/2002 10:15:54AI SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Revert asozf <br /> Pagel <br /> Run by Facility Information as of 3/14/2002 <br /> Record Selection Criteria: Facility ID FA0003940 <br /> Make changes/corrections in RED Ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner 1D OW0002913 New Owner ID <br /> Owner Name NEIL, RON <br /> Owner DBA (FORMER)P E OHAIR& COMPANY <br /> Owner Address 505 LOCKE STE 200 <br /> ST LAURENT, QUEBEC, CANAD, <br /> Home Phone Not Specified <br /> Work/Business Phone 514-904-5309 <br /> Mailing Address 505 LOCKE, STE 200 <br /> ST LAURENT, QUEBEC, CANAD, <br /> Care of RON NEIL <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003940 <br /> Facility Name P E CHAIR&COMPANY(FORMER) <br /> Location 1102 S AURORA ST <br /> STOCKTON, CA 95206 <br /> Phone 209-948-8801 <br /> Mailing Address <br /> Care of <br /> Location Code 01 -STOCKTON APN. <br /> BOS District 001 -GUTIERREZ, STEVE SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> AccountlD AR0003548 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name APEX ENVIROTECH INC (Circle one) <br /> Account Balance as of 3/14/2002: $-267.00 (Circle One) <br /> Transfer to Active/Inactve <br /> New OwneR Delete <br /> Program/Element and Description Record ID Employee ID and Name Status <br /> 2381 -UST FACILITY(BEFORE 1/84) PR0231015 EEO000008-LETITIA BRIGGS Inactive Y N A I D <br /> 2960-RWQCB CLEAN UP SITE PR0518265 EE0000684-MICHAEL INFURNA Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator"agent of same,ackno.Nedge that all site,and/or project specific,PHS/EHD hourlycharges associated 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 Ordinate Codes and/or Standards and <br /> State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid� Date <br /> Water System to be TRANSFERED: "$150.00= Amount Paid Date <br /> Payment Type Check Number ( ') Q') Received by <br /> REHS: Date /_/ Account out: Date <br /> COMMENTS: <br /> PAYtVILN T <br /> -RECEIVED <br /> MAR 13 2002 <br /> -�AN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> (:NVIRONhiENTP,L HEALTH DIVISION <br /> \\Phs-ehsgl-nt\apps\Envisbns\Reports\5021.rpt <br />