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Date run 8!2612008 8:50:54AA SAN JOh -IN COUNTY ENVIRONMENTAL HEAL' DEPARTMENT Report 45021 <br /> Run by g <br /> Pa e1 <br /> Facility Information as of 8/26/200tvd <br /> Record Selection Criteria: Facility ID FA0016638 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN 1 Fed Tax ID <br /> Owner ID OW0002052 New Owner ID <br /> Owner Name NEWARK GROUP INC <br /> Owner DBA NEWARK SIERRA PAPERBOARD CORP <br /> Owner Address 17 BL4NCHARD <br /> NEWARK, NJ 07105 <br /> Home Phone 973-589-6853 <br /> Work/Business Phone 908-276-4000 <br /> Mailing Address PO BOX 58044 <br /> SANTA CLARA, CA 950528044 <br /> Care of <br /> FACILITY FILE INFORMATI <br /> Facili D A0016638 <br /> Facility Na SIERRA PAPERBOARD CORP <br /> Location 800 W CHURCH ST <br /> STOCKTON, CA 95203 <br /> Phone 209-466-7088 <br /> Mailing Address PO BOX 58044 <br /> SANTA CLARA, CA 950528044 <br /> Care of NEWARK SIERRA PAPERBOARD CORP <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 001 -GUTIERREZ, STEVE Fax <br /> APN 14523004 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0029448 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner � Facility 1 Account <br /> Account Name ADVANCED GEOENVIRONMENTAL (Circle one) <br /> Account Balance as of 812612008: $0.00 <br /> (Circe One) <br /> Transfer to Activellnactve <br /> Program/Element and Description Record ID Employee ID and Name Statu New Owner? <br /> 2950-ENVIRON ASSESS PRO524783 EE0000942-MARGARET LAGORIO A ive Y N ' D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,an project spec,PHSlEHD hourty charges ass 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 a ante with all applicable Ordinate Codes andtor Standards and <br /> State andlor Federal Laws. <br /> APPLICANT'S SIGNATURE: Date I I <br /> Program Records to be TRANSFERED: $20.00= Amount Paid Date I I <br /> Water System to be N FER '$372.00= Amount Paid Date ! 1 <br /> Payment Type Check Number Receied by <br /> REHS: Date lAfo1 Account out: & Date 2 1 Q <br /> COMMENTS: <br /> 11phs-ehsgl-nt\apps\envisionslreportsk502l.rpt <br />