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Date run 4/14/2004 1:00:39PK SAN JOA("i N COUNTY ENVIRONMENTAL HEAL-F-- EPARTMENT Report#5021 <br /> Rim by Paget <br /> �-� Facil'ity Information as of 4/14/200 <br /> Record Selection Criteria: Facility ID FA0013775 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) _ <br /> OWNERSHIP CHANGE(date) _. <br /> OWNER FILE INFORMATION <br /> Owner ID OW0001479 New Owner ID <br /> Owner Name SILGAN CONTAINERS MFG CORP <br /> Owner DBA SILGAN CONTAINERS CORP <br /> Owner Address 1815 NAVY DR <br /> STOCKTON, CA 95206 <br /> Home Phone Not Specified <br /> Work/Business Phone 818-348-3700 <br /> Mailing Address PO BOX 270 <br /> STOCKTON, CA 95201 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0013775 <br /> Facility Name SILGAN CONTAINERS MFG CORP <br /> Location 1815 NAVY DR <br /> STOCKTON, CA 95206 <br /> Phone 209-466-7031 <br /> Mailing Address PO BOX 270 <br /> STOCKTON, CA 95201 <br /> Care of CHIPPONERI, JIM <br /> Location Code 01 - STOCKTON APN: <br /> BOS District 001 - GUTIERREZ, STEVE SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0023160 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name TRIHYDRO CORPS 11,G1A t-t CoNTAu►�Ei2 s (Circle One) <br /> Account Balance as of 4/14/2004: $600.50 N • H1+t A CT P RN 16H <br /> 1&Pgpo OX N A 1z' '6-7''�O fl v (Circle One) <br /> TransActiveve <br /> New Ownerwner? Delete <br /> Program/Element and Description Record ID Employee ID and Nam � Status <br /> 2960-RWQCB CLEAN UP SITE(SLIC) PR0518241 EE0000942-MARGARET LAGORIO 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: `$155.00= Amount Paid Date <br /> Payment4E==— <br /> Check Number Re eived by <br /> RENS: Date ! / Account out: _ Date4� / � l._t� — <br /> C NTS <br /> 1/11)P� I-A"-dd <br /> \\Phs-ehsql-nt\apps\Envisions\Reports\5021.rpt <br />