Laserfiche WebLink
Date run 6/6/2005 8:51:29AM SAN JOSJIN COUNTY ENVIRONMENTAL HEA#DEPARTMENT Repo x5021 <br /> Run by Pagel <br /> Facility Information as of 6/6/20 <br /> Record Selection Critena: Facility ID FA0004570 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNER FILE INFORMATION OWNERSHIP CHANGE(date) <br /> Owner ID OW0003473 New Owner ID <br /> Owner Name SPRECKELS SUGAR CO <br /> Owner DBA SPRECKELS SUGAR COMPANY <br /> Owner Address pe gj � 2 05e D c,L-1 a(Z <br /> TRACY, CA 9533&ar� <br /> Home Phone Not Specified <br /> Work/Business Phone 209-835-3210 <br /> Mailing Address PO -B(" <br /> TRACY, CA 95378 S <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0004570 <br /> Facility Name SPRECKELS SUGAR CO <br /> Location 20500 HOLLY DR <br /> TRACY, CA 95378 <br /> Phone 209-835-3210 Xe <br /> Mailing Address P@� MGtCPXS Cdyr. <br /> TRACY, CA 95378 O l <br /> Care of SPRECKELS SUGAR CO 1549J. qs3vq1 (4:ei <br /> Location Code 03 -TRACY U APN:212-160-02-2 <br /> BOS District 005-ORNELLAS, LEROY SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0004353 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name SPRECKELS SUGAR CO (Circle One) <br /> Account Balance as of 6/6/2005: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Omen Delete <br /> 2960-RWQCB CLEAN UP SITE(SLIC) PR0009165 EE0000997-HARLIN KNOLL Active Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523636 EE0004045-TED TASIOPOULOS 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 I / <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: '$155.00= Amount Paid Date <br /> Payment'T�{ge�� e�—Check Number Received by <br /> REHS: !�'D�M.; Date �o /_�/� Account out: _ tL- Date / & <br /> COMMENTS: <br /> \\phs-ehsq I-nt\apps\envis ions\reports\5021.rpt <br />