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: LAURIEB Joaquin County PHS/EH <br /> 0 <br /> Run by Report #5021 <br /> FACILITY INFORMATION as of 07/08/99 <br /> - ------ - - - - ---- - - ------ - ---------------------------------------------- <br /> Make changes/corrections in RED pen or pencil: <br /> OWNER FILE INFORMATION INFORMATION CHANGE (date) : <br /> OWNERSHIP CHANGE (date): <br /> OWNER ID: 005584 New Owner ID: 00 <br /> owner Name: SOUZA, ANTHONY F & GLORIA P <br /> Owner DBA: SOUZA PROPERTY <br /> Owner Address: 105 E 10TH ST <br /> TRACY, CA 95376 <br /> Home Phone: 209-835-8330 <br /> Soc Sec# / Tax ID#: <br /> ownership Type: 01 CORPORATION <br /> Mailing Address: 105 E 10TH ST <br /> care of: ANTHONY F & GLORIA P SOUZA <br /> TRACY, CA 95376 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 006798 <br /> Facility Name: SOUZA PROPERTY <br /> Location: FABIAN & LAMMERS RD <br /> TRACY 95376 <br /> Phone: 209-835-8330 <br /> Mailing Address: 105 E 10TH ST <br /> care of: ANTHONY F & GLORIA P SOUZA <br /> TRACY, CA 95376 <br /> Location Code: 9 9 APN: 238-080-01 <br /> BOS District: 005 SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT ID: 0009397 New Account ID: 000 <br /> Mail Invoices to: Account Mail invoices to: Owner / Facility / Account <br /> Account Name: STANDARD PACIFIC OF NO CALIF (circle one) <br /> Account Balance as of 0 7/0 8/9 9 : $0 . 00 (Circle on <br /> Record UST(s) Transfer to Activate Inactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> _____ _______ <br /> ---------------------------------- <br /> -------------------------------- <br /> 2950 ENVIRON ASSESS PR505477 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 identified as the <br /> BILLING PARTY on this form. I also certify that all operations will be performed in accordance with all applicable SAN JOAQUIN <br /> COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. <br /> Date <br /> APPLICANT'S SIGNATURE: <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 <br /> ate / /Payment Type Check # Recvd by <br /> --------------- -----------------------------------/� <br /> �--- <br /> REHS or COUNTER SUPV: Date/ /0 ACCT out: Date 07/ V�Q/7 UNIT/File: / / <br />