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�� O • �JOa in Count PHS/EHD� • Report #5021 <br /> Run by SANDY Sa qu Y <br /> FACILITY INFORMATION as of 05/04/98 <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <br /> Make changes/corrections in RED pen or pencil: <br /> OWNER FILE INFORMATION INFORMATION CHANGE (date): <br /> OWNERSHIP CHANGE (date): <br /> OWNER ID: 000518 New owner ID: OO <br /> owner Name: NESTLE FOODS CORP <br /> owner DBA: NESTLE FOODS CORP I <br /> owner Address: 230 INDUSTRIAL <br /> RIPON, CA 95366 <br /> Home Phone: <br /> Soc Sec# / Tax ID#: <br /> ownership Type: 01 CORPORATION <br /> Mailing Address: 230 INDUSTRIAL n <br /> care of: NESTLE FOODS CORP <br /> RIPON, CA 95366 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 000649 <br /> Facility Name: NESTLE/HILLS BROS P� <br /> Location: 230 INDUSTRIAL to-WWI CAS' p-1. <br /> RIPON 95366 \ <br /> Phone: 209-599-4161 <br /> ,( p0 Vit° gOO 1J, P <br /> Mailing Address: 800 N BRAND BLVD �(and/ 1 <br /> Care of: NESTLE USA BEVERAGE DIV INC ` <br /> GLENDALE, CA 91203 <br /> I wel <br /> IN11 <br /> Location Code: 05 APN;,/' <br /> BOS District: 005 SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT ID: 0000648 New Account ID: 000 <br /> Mail Invoices to: Facility Mail Invoices to: Owner-/ Facility / Account <br /> Account Name: NESTLE/HILLS BROS (Circle one) <br /> Account Balance as of 05/04/98 : $351 . 00 (Circle one) <br /> Record UST(s) Transfer to Activate / Inactivate. <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ <br /> 2960 RWQCB CLEAN UP SITE PR009051 0756 OZ ACTIV Y N A I D <br /> 2229 GEN 50<250 TONS PERMIT PR220104 0988 FOLEY INACT VE Y N A I D <br /> 2381 UST FACILITY (BEFORE 1/84) PR505647 3973 MCCLELLON INACT VE 1 Y N A I D <br /> 4630 NTNC ws WA460794 0756 INAc IVE Y N A 1 D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1, the undersigned owner, -Pe r or agent of same, acknowledge that all site and/or <br /> project specific PHS/EHD hourly charges associated with this facility or ctivity will be billed to the party identified as the <br /> BILLING PARTY on this form. I also certify that all operations will be pe formed in accordance with all applicable SAN JOAQUIN <br /> COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <br /> - - - - <br /> PR Records to be TRANSFERED: x 820.00 = Amo nt Paid Date_ <br /> _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ <br /> Water System to be TRANSFERED: x 8150.00 = Amount Paid Date_/ / <br /> Payment Type Check # Recvd by <br /> REHS or COUNTER SUPV:�_ Date—/_/_ ACCT out: Date / 7 UNIT/File: /'_/ <br />