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Date run 10/7/2004 10:09:58AI SAN J*JIN COUNTY ENVIRONMENTAL HEAT DEPARTMENT Report#6021 <br /> Run by .I Pagel <br /> Facility Information as of 10/7/2004 <br /> Record Selection Criteria: Facility ID FA0004090 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0000857 New Owner ID <br /> Owner Name DIAMOND OF CALIFORNIA <br /> Owner DBA DIAMOND OF CALIFORNIA <br /> Owner Address 1050 DIAMOND ST <br /> STOCKTON, CA 95205 <br /> Home Phone Not Specified <br /> Work/Business Phone Not Specified <br /> Mailing Address PO BOX 1727 <br /> STOCKTON, CA 95201 <br /> Care of ACCOUNTING <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0004090 <br /> Facility Name DIAMOND WALNUT GROWERS INC <br /> Location 1050 DIAMOND ST <br /> STOCKTON, CA 95205 <br /> Phone 209-467-6000 <br /> Mailing Address PO BOX 1727 <br /> STOCKTON, CA 95201 <br /> Care of DIAMOND WALNUT GRWS/M.LESCISIN <br /> Location Code 01 -STOCKTON APN:155 320 19 5 <br /> BOS District SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0003750 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name DIAMOND WALNUT GROWERS INC (Circle One) <br /> Account Balance as of 10/7/2004: $0.00 <br /> F/�pc/y (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID o5d No Status Now Owner? Delete <br /> 2960-RWQCB CLEAN UP SITE(SLIC) PR0001781 EE000 2-SAM VIG Active Y N A D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent o(same cknowledge that all site,and/or project specific,PHS/EHD hourly charges associated with this <br /> facility or activity will be billed to the parry 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 t e T NSFERED: '$155.00= Amount Paid <br /> Payment Type Check Number Received by ,! <br /> REHS: Date Account out: 20(� Date / / 07 <br /> COMMENTS: <br /> \\phs-ehsgl-nt\apps\envisions\reports\5021.rpt <br />