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Date run 12/29/2005 8:28:34A SAN JO UIN COUNTY ENVIRONMENTAL HEA' .I DEPARTMENT Report#5021 <br /> Run by 4006 %%-.1 Paget <br /> Facility information as of 12/2912(�Tb� <br /> Record Selection Criteria: Facility ID FA0016638 <br /> Make changes/corrections in RED irk or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0002052 New Owner ID <br /> Owner Name NEWARK GROUP INC <br /> Owner DBA NEWARK SIERRA PAPERBOARD CORP <br /> Owner Address 17 BLANCHARD <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 INFORMATION <br /> Facility ID FA0016638 <br /> Facility Name NEWARK 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 APN:14523004 <br /> BOS District 001 -GUTIERREZ, STEVE SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0029448 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner ! Facility / Account <br /> Account Name ADVANCED GEOENVIRONMENTAL (Circle One) <br /> Account Balance as of 12129/2005: $0.00 <br /> (Circle One) <br /> Transfer to Activellnactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2950-ENVIRON ASSESS PR0524783 EE0000942-MARGARET LAGORIO Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that ail site,and/or project specific,PHSIEHD 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 / 1 <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date I I <br /> Water System to be TRANSFERED: "$372.00= Amount Paid Date / 1 <br /> Payment Type Check Number Received by <br /> RENS: Date / 1 Account out: Date ! 1 <br /> COMMENTS: <br /> 1 <br /> Ilphs-ehsgl-ntlappslenvisionslreports15021.rpt *ftwo <br />