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Date <br /> Run by 3/23/2005 <br /> /32005 3:56:17Pk SAN JOIN COUNTY ENWIRONSIENTAL HEA DEPARTMENT Report#5021 <br /> hl Pagel <br /> Facility Information as of 3/23/2005 <br /> Record Selection Criteria: Facility ID FA0016022 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNER FILE INFORMATION OWNERSHIP CHANGE(date) <br /> Owner ID OW0007268 Case Number: H02631 New Owner 1D : <br /> Owner Name GARY SCANNAVINO <br /> Owner DBA CHEROKEE FREIGHT LINES (TRUCK <br /> Owner Address <br /> Home Phone Not Specified <br /> Work/Business Phone 209-931-3574 <br /> Mailing Address 5463 E CHEROKEE RD <br /> STOCKTON, CA 95215 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016022 <br /> Facility Name CHEROKEE FREIGHT LINES <br /> Location 5463 E CHEROKEE RD <br /> STOCKTON, CA 952151120 <br /> Phone 209-931-3574 <br /> Mailing Address 5463 E CHEROKEE RD <br /> STOCKTON, CA 952151100 <br /> Care of <br /> Location Code 99 - UNINCORPORATED AREA APN:08712143 <br /> BOS District 002 - MARENCO, DARIO SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0027942 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name CHEROKEE FREIGHT LINES (Circle One) <br /> Account Balance as of 3/23/2005: $0.00 <br /> (Circe One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2965-H2O QUAL SITE PROJECT PRO523785 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,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 Oroinace 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 /> REHS: Date_/ / Account out: Date <br /> COMMENTS: <br /> Add <br /> \\phs-ehsgl-nt\apps\envisions\reports\5021.rpt <br />