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Dale run 7/8/2005 4:33:07PM SAN J IN COUNTY ENVIRONMENTAL HEA10 DEPARTMENT Report#5021 <br /> Run by 4006 Pagel <br /> Facility Information as of 7/8/2005 <br /> Record Selection Catena: Facility ID FA0015803 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0012728 New Owner ID <br /> Owner Name RICHLAND PLANNED COMMUNITIES <br /> Owner DBA <br /> Owner Address 2220 DOUGLAS BLVD STE 290 <br /> ROSEVILLE. CA 95661 <br /> Home Phone 916-782-3330 <br /> Work/Business Phone Not Specified <br /> Mailing Address 2220 DOUGLAS BLVD <br /> ROSEVILLE, CA 95661 <br /> Care of RICHLAND PLANNED COMMUNITIES <br /> FACILITY FILE INFORMATION Site Mitigation Facilitl <br /> Facility ID FA0015803 <br /> Facility Name RICHLAND PLANNED COMMUNITIES <br /> Location BOWMAN MANILA FREWERT <br /> STOCKTON, CA 95202 <br /> Phone <br /> Mailing Address 2220 DOUGLAS BLVD <br /> ROSEVILLE, CA 95661 <br /> Care of RICHLAND PLANNED COMMUNITIES <br /> Location Code APN: <br /> BOS District SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0027426 [ New Account ID: <br /> Mail Invoices to Account1 ) Mail Invoices to: Owner / Facility / Account <br /> Account Name ENGEO INCORPORATED �/ IaJ `� (Circleone) <br /> Account Balance as of 7/8/2005: %e-Or � C/ <br /> (Circe One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Rec mployee ID and Name Status Nev Owner? Delete <br /> 2965-WATER QUALITY SITE PROJECT PR0523386 0000684-MICHAEL INFURNA Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the on sl werstu u agent of same,acknowledge that all site,and/or projecl specific,PHS/EHD hourly charges associated with this <br /> facility or activity will be billed to the party identified as the OWNER on this farm. I also certify that all operations will be perfumed in accordance with all applicable Ordinaus Codes and/u 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 82-7 ctf-Date 7 / F-/ <br /> Payment Type '� Check Number —7-13-1 Received by <br /> REHS: Date I / Account out: Date_/ / <br /> COMMENTS: <br /> pz� <br /> \\phs-ehsgl-nt\apps\erMsions\repons\5021.rpt <br />