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Run by : STAFF San Joaquin County PHS/EHD <br /> FACILITY- INFORMATION as of 07/30/97 Report #5021 <br /> OWNER FILE INFORMATION Make changes/corrections in RED pen or`pencil: <br /> INFORMATION CHANGE (date) : <br /> OWNERSHIP CHANGE (date) ; <br /> OWNER TD: 004851 <br /> Owner Name: BOGGETTI, ROBERT & SON New owner ID; 00 <br /> Owner DBA; ROBERT BOGGETTI & SON <br /> Owner Address: 700 W LINNE RD <br /> TRACY, CA 95376 <br /> Home Phone: <br /> SOC Sec# / Tax ID#; <br /> Ownership Type: 01 CORPORATION <br /> Mailing Address: PO BOX 797 <br /> Care of: ROBERT BOGGETTI & SON <br /> TRACY, CA 95376 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 006083 <br /> Facility Name: ROBERT BOGGETTI & SON <br /> Location: 700 W LINNE RD <br /> TRACY 95376 <br /> Phone: <br /> Mailing Address: PO BOX 797 <br /> Care of: ROBERT 13OGGETTI & SON <br /> TRACY, CA 95376 <br /> Location Code: APN: <br /> BOS District: 005 SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT ID: 0007080 New Account ID: 000 <br /> Mail Invoices to; ACCourit Mail Invoices to: Owner _/Facility / ACcount <br /> Account Name: ADVANCED ENVIRON CONCEPTS INC (Circle one) <br /> Account Balance as of 0 7/3 0/9 7 : $569 - 40 (Circle one) <br /> Record UST(s) Transfer to Activate / Inactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> ------------------------------------------------------------------------------- <br /> ,,2,,333333--- FARM UST #1 FACILITY PR504114 1965 YOSHIOKA INACTIVE 4 Y N A I D <br /> yx�0 ENVIR0P11eSESS -PR506469 0684 INFURNA -- ACTIVE V" - ----- Y`-N AVI I D <br /> ------------ -- --------- ---------- <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1, 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 he 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 /> 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 /> Payments Type Check # Recvd by <br /> RENS or COUNTER SUPVY �r`�' Date /�1j y` ACCT out: nate/�/�Z UNIT/File <br /> V � y <br />