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Date run 2/5/2007 2:40:44PM SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 2/5/2007 <br /> Record Selection Criteria: Facility ID FA0015033 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0012023 New Owner ID <br /> Owner Name UNION PACIFIC RAILROAD CO <br /> Owner DBA TEXACO, TRADING &TRANSPORT <br /> Owner Address PO BOX 7764 <br /> BURBANK, CA 91510 <br /> Home Phone Not Specified <br /> Work/Business Phone Not Specified <br /> Mailing Address PO BOX 7764 <br /> BURBANK, CA 91510 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015033 <br /> Facility Name TAOC TRACY GRAVEL PITS <br /> Location 26805 S MACARTHUR DR <br /> TRACY, CA 95376 <br /> Phone <br /> Mailing Address 26805 S MACARTHUR DR <br /> TRACY, CA 95376 <br /> Care of <br /> Location Code APN:24614001 <br /> BOS District SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0025699 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name CHEVRON-ENVIRONMENTAL MGMT CO (Circle One) <br /> Account BOan/ce as of 2//5/2007: $0.00 <br /> 29 6 d✓ '/ Owner? <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID ✓ Employee ID and Name / Status New OwneR Delete <br /> oor n Fnitnanni ecc=�� PRO522069 EE0000684-MICHAEL INFURNA 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 <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date / ! <br /> Water System to be TRANSFERED: '$372.00= Amount Paid Date <br /> Payment Type Check Number Receiv d <br /> REHS: Date ! Account out: Date l Ce 10 <br /> COMMENTS: <br /> \\phs-ehsql-nt\apps\envisions\reports\5021.rpt <br />