Laserfiche WebLink
[Record <br /> te run 12t:3/203 10:40:52/ SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> n by ! ' Report#5021 <br /> Facility Information as of 12/23/2003 Paget <br /> Selection Criteria: Facility ID FA0014531 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNER FILE INFORMATION OWNERSHIP CHANGE(date) <br /> Owner ID OW0011558 New Owner ID <br /> Owner Name MURDOCH, ROBERT K <br /> Owner DBA CITY OF STOCKTON <br /> Owner Address 2500 NAVY DR <br /> STOCKTON, CA 95206 <br /> Home Phone 209-937-8734 <br /> Work/Business Phone Not Specified <br /> Mailing Address 2500 NAVY DR <br /> STOCKTON, CA 95206 <br /> Care Of ROBERT K MURDOCH <br /> FACILITY FILE INFORMATION <br /> FacilityID FA0014531 <br /> Facility Name I��YrttpccTtf- �rDf}, rjp YYIF <br /> Location 2500 NAVY DR / C <br /> STOCKTON, CA 95206 <br /> Phone 209-937-8734 <br /> Mailing Address 2500 NAVY DR idU <br /> STOCKTON, CA 95206 <br /> Care of CITY OF STOCKTON - MUD <br /> Location Code APN: <br /> BOS District SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0024714 NewAccount ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name MURDOCH, ROBERT K (Circle One) <br /> Account Balance as of 12/23/2003: $316.20 <br /> Program/Element and Description Transfer (Circle One) <br /> RecoN ID Owner Active/Inaclve Employee ID and Name Status New Owner? Delete <br /> 2950-ENVIRON ASSESS PR0521409 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 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: "$155.00= Amount Paid Date <br /> Payment Type Check Number Rece' by <br /> RENS: Date / / Account out: Date <br /> COMMENTS: <br /> \\Phs-ehsql-nt\apps\Envisions\Reports\5021.rpt <br /> _J <br />