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SITE INFORMATION AND CORRESPONDENCE
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2900 - Site Mitigation Program
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PR0009146
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
7/11/2019 1:32:43 PM
Creation date
7/11/2019 11:16:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0009146
PE
2960
FACILITY_ID
FA0004093
FACILITY_NAME
LIGHTHOUSE SCHOOL
STREET_NUMBER
222
Direction
N
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95202
APN
13910022
CURRENT_STATUS
02
SITE_LOCATION
222 N EL DORADO ST
P_LOCATION
01
QC Status
Approved
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EHD - Public
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Run by STAFF S"MK Joaquin County PHS/EHD �'� Report #5021 <br /> FACILITY INFORMATION as of 08/21/96 <br /> ------------------------------------------------------------------------------- <br /> Make changes/corrections in RED pen or pencil: <br /> OWNER FILE INFORMATION INFORMATION CHANGE (date) : <br /> OWNERSHIP CHANGE (date) : <br /> OWNER ID: 002669 New Owner ID: 0 0 <br /> Owner Name: AMERICAN SAVINGS BANK <br /> Owner DBA: AMERICAN SAVINGS BANK r/ <br /> Owner Address: ( 7 <br /> Home Phone: 2r4D-9 --S"g-6`2_4'3_4_ 7 I L f .2! z 4 Q 7 3 <br /> Soc Sec# / Tax ID#: <br /> ownership Type: 03 PARTNERSHIP <br /> Mailing Address: 400 E MAIN ST 4TH FLOOR <br /> Care of: AMERICAN SAVINGS BANK <br /> STOCKTON, CA 95206 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 004093 <br /> Facility Name: TMSAn.T—SAVINGS—BANK .( <br /> v' <br /> Location: 222 N EL DORADO ST <br /> STOCKTON 95202 <br /> Phone: 209-546-2434 <br /> Mailing Address: 305 N ELPgR160 ST <br /> Care of: CITY OF OCKTON/R PALMQUIST <br /> STOC N, CA 95201 <br /> Location Code: 01 APN: 139-100-19-2 <br /> BOS District: SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT ID: 0003 753 New Account ID: $ <br /> Mail Invoices to: Account Mail Invoices to: Owner Fac 1 Account <br /> Account Name: AMERICAN SAVINGS BANK ���j ( cle <br /> Account Balance as of 08/21/96 : -02-6-5--2�?�• � �Q�J�P.w (Circle ne) <br /> Record D UST(s) Transfer to Activate / nactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> ------------------------------------------------------------------------------- <br /> 2953 LCL HW CLEANUP SITE PR009146 ,0684 INFURNA ACTIVE Y N A I D <br /> ------------------------------------------------------------------------------- <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site and/or <br /> project specific PHS/EHD hourly charges associated with this facility or activity will be billed to the party ident fied as the <br /> BILLING PARTY on this form. I also certify that all operations will be performed in accordance with all applicabl SAN JOAQUIN <br /> COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> ' <br /> PR Records to be TRANSFERED: x $20.00 = Amount Paid Date—/—/ <br /> Water System to be TRANSFERED: x $150.00 = Amount Paid Date <br /> Payment Type Check # Recvd by <br /> ==========_ — --y'�------ ttt,,,,,,...���//��� <br /> REHS or COUNTER SUPV: Date O /�� / ACCT out: Date /0 �6 UNIT/File: / / <br />
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