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Date run 12/29/2005 8:28:59A SAN JO TTIN COUNTY ENVIRONMENTAL HEA DEPARTMENT Report#5021 <br /> Run by 4006 ,11%,/ Pagel <br /> T Facility as as of 12/29/25 <br /> Record Selection Criteria: Facility ID FA0012708 <br /> Make changes/corrections in RED ink 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 FA0012708 <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 /> i <br /> BOS District 001 -GUTIERREZ, STEVE SIC Code: _ <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0021184 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name MACTEC ENGINEERING &CONSULTING (Circle One) <br /> Account Balance as of 12/29/2005: $-279.00 1 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete i <br /> 2950-ENVIRON ASSESS PR0516614 EE0000942-MARGARET LAGORIO Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project spec,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. i <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: "$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: '$372.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br /> f <br /> A� <br /> \\phs-ehsgl-nt\apps\envisions\reports\5021.rpt <br />