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Run by : STAFF Sin Joaquin County PHS/EHD Report 45021 <br /> FACILITY INFORMATION as of 02/11/97 <br /> ------------------------------------------------------------------------------- <br /> Make changes/corrections in RED pen or pencil: <br /> OWNER FILE INFORMATION INFORMATION CHANGE (date) : <br /> OWNERSHIP CHANGE (date): <br /> OWNER ID: 006100 New Owner ID: 0 0 <br /> owner Name: TRAINA, OLIVIA EST &J.BARNES <br /> Owner DBA: <br /> Owner Address: 1215 CAMINO RAMON <br /> SAN JOSE, CA 95125 <br /> Home Phone: 408-293-2626 <br /> Soc Sec# / Tax ID#: <br /> Ownership Type: 01 CORPORATION <br /> Mailing Address: 1215 CAMINO RAMON <br /> care of: OLIVIA TRAINS EST & J. .BARNES <br /> SAN JOSE, CA 95125 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 007387 <br /> Facility Name: TRAINA PROPERTY <br /> Location: 29900 MACARTHUR DR <br /> TRACY 95376 <br /> Phone: <br /> Mailing Address: 1215 CAMINO RAMON <br /> care of: OLIVIA TRAINS EST & J. BARNES <br /> SAN JOSE, CA 95125 <br /> Location Code: 0 3 APN: <br /> Bos District: O 0 5 SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT ID: 0 011107 New Account ID: 000 <br /> Mail Invoices to: Account Mail Invoices to: Owner / Facility / Account <br /> Account Name: TEICHERT AGGREGATES (Circle one) <br /> Account Balance as of 02/11/97 : $23 .40 (Circle one) <br /> Record UST(s) Transfer to Activate / Inactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> 2950 ENVIRON ASSESS PR506388 0451 SASSON 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 /> 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 /> Payment Type Check # Recvd by <br /> — ---------------------------------------------- <br /> REHS or COUNTER SUPV: Date—/—/ ACCT out: Date—/—/— UNIT/File: / / <br />