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SAN�QUIN COUNTY PUBLIC HEALTH SEF&S Report u: 5023 <br /> Date run 10/18/01 11:29:21AM Page 1 <br /> le'001-A <br /> Ron by Facility 16formatior.as of 10/18/01 <br /> Record Selection Criteria: Facility ID FA0006852 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> f/�ISTING j OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID: OW0005622 New wner ID <br /> Owner Name: VOLPI, LEO AND EVA <br /> Owner DBA: A VOLPI AND SON INC <br /> Owner Address: 4621 BRIDGEWATERCIRo <br /> STOCKTON, CA 95219 7 0 <br /> Home Phone: 209-473-2265 <br /> Work/Business Phone: 209-464-6768 <br /> Mailing Address: PO BOX 58 <br /> HOLT, CA 95234 <br /> Care of: BEV CEREDA <br /> FACILITY FILE INFORMATION <br /> Facility ID: FA0006852 <br /> Facility Name: OCCIDENTAL CHEMICAL CORP <br /> Location: 1904 W CHARTER WY <br /> STOCKTON, CA 95205 <br /> Phone: 209-472-2020 <br /> Mailing Address: PO BOX 728 <br /> NIAGRA FALLS, NY 143020728 <br /> Care of: JOHN NICHTER <br /> Location Code: 01 - STOCKTON APN: <br /> BOS District: 001 -GUTIERREZ, STEVE SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID: AR0009556 New Account ID: <br /> Mail Invoices to: Account Mail Invoices to: Owner/Facility/Account <br /> Account Name:_3a&4,TE�� (Circle Tm= <br /> Account Balance as of 10/18/01: $43.50 <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-RWOCB CLEAN UP SITE PR0505548 EE0000684-MICHAEL INFURNA Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andlor 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: '$150.00= Amount Paid Date <br /> Payment Type Check Number Credit Card Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br /> \\phs-ehsgl-nt\apps\envisions\reports\5023.rpt <br />