Laserfiche WebLink
Date run 2/13/2004 2:47:06PK SAN JOAM COUNTY ENVIRONMENTAL HEAL EPARTMENT <br /> Report#5021 <br /> Run by Facility Information as of 2/13/20 Pagel <br /> Record Selection Criteria: Facility ID FA0004,178 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORM" <br /> � N-gw Owner ID <br /> to ((( �s� �2 J9.� �y�l�tai C LAIC 2— <br /> 1 CO <br /> Owne. �� ^ e�t7 Lt�a 4 /lnnG✓c7� YGn <br /> Home F-. <br /> Work/Business Ph(, ` ,,;ified <br /> Mailing Address ,(00 S BANTA RD 4,0 <br /> TRACY, CA 95376 <br /> Care of ALL PURE CHEMICAL CO C�- <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0004478 <br /> Facility Name ALL PURE CHEMICAL CO �t tr�1 °/�-� ��^`P� t sol <br /> Location 26700 S BANTA RD <br /> TRACY, CA 95376 <br /> Phone 209-835-5424 <br /> Mailing Address 26700 S BANTA RD <br /> TRACY, CA--95376 <br /> Care of ALL PURECHEM-I AL-CO <br /> Location Code 99 - UNINCORPORATED AREA APN:36ALLPU26 <br /> BOS District 005-ORNELLAS, LEROY SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0004160 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> (Circle One) <br /> Account Name ALL PURE CHEMICAL CO <br /> Account Balance as of 2/13/2004: $0.00 (Circle One) <br /> Transfer to Active/Inactve <br /> New Owner? Delete <br /> Program/Element and Description <br /> Record ID Employee ID and Name Status <br /> 2960-RWQCB CLEAN UP SITE(SLIC) PR0506297 EE0000997-HARLIN KNOLL Active Y N A I D <br /> 4630-NTNC WATER SYSTEM <br /> WA0461320 EE0001699-JOHNNY YOAKUM 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 <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 Ordinace 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: *$155.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> RENS: ILK Date 3- / /C2Account out: Date--aiLL <br /> / <br /> COMMENTS: <br /> \\Ph s-ehsq I-n t\apps\Envisions\Reports\5021.rpt <br />