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Date run 7/19/2013 2:55:52PK SAN JOAReport#5021 <br /> N COUNTY ENVIRONMENTAL HEALWEPARTMENT Pagel <br /> Run by Facility Information as of 7/19/2013 <br /> Record Selection Criteria: Facility ID FA0018711 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0003393 New Owner ID <br /> Owner Name OLIN CORPORATION <br /> Owner DBA <br /> Owner Address 700 LOUISIANA ST STE 4300 <br /> HOUSTON, TX 77002 <br /> Home Phone 713-570-3200 <br /> Work/Business Phone 209-835-5424 <br /> Mailing Address 700 LOUISIANA ST STE 4300 <br /> HOUSTON, TX 77002 <br /> Care of MUSE, ELIZABETH <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0018711 <br /> Facility Name OLIN CHLOR ALKALI PRODUCTS <br /> Location 26700 S BANTA RD <br /> TRACY, CA 95376 <br /> Phone 209-835-5424 x026 <br /> Mailing Address 26700 S BANTA RD <br /> TRACY, CA 95376 <br /> Care of INKES, JEFF <br /> Location Code 99 - UNINCORPORATED P Alt Phone <br /> BOS District 005 - ELLIOTT, BOB Fax <br /> APN 25215008 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name LISA KAY TUCK <br /> Title <br /> Day Phone 209-835-5424 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0033227 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name OLIN CHLOR ALKALI PRODUCTS (Circle One) <br /> Account Balance as of 7/19/2013: $-105.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2960-RWQCB SITE PR0506297 EE0000997-HARLIN KNOLL 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 project specific,PHS/EHD hourly charges associated with this 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 and/or Standards and State andlor <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: "$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br />