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Date run 8/5/2010 3:51:47PM SAN JOVUIN CENVIRONMENTAL HEADEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 8/5/20 <br /> Record Selection Criteria: Facility ID FA0007271 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0002955 New Owner ID <br /> Owner Name LINCOLN PROPERTIES LTD <br /> Owner DBA <br /> Owner Address 615 LINCOLN CENTER <br /> STOCKTON, CA 95207 <br /> Home Phone 209-478-9200 <br /> Work/Business Phone 209-478-9200 <br /> Mailing Address 615 LINCOLN CENTER <br /> STOCKTON, CA 95207 <br /> Care of W ILBUR SMITH <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0007271 <br /> Facility Name LINCOLN CNTR ENV REMEDIATION TRUST <br /> Location PACIFIC AVE <br /> STOCKTON, CA 95207 <br /> Phone 510-237-1782 <br /> Mailing Address 137 PARK PLACE <br /> RICHMOND, CA 94801 <br /> Care of MARK ADAMS <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 002- RUHSTALLER, LARRY Fax <br /> APN EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name MARK ADAMS <br /> Title <br /> Day Phone 510-237-1782 <br /> Night Phone 510-237-1782 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0010736 NewAccount ID: <br /> Mail Invoices to Account \ Mail Invoices to: Owner / Facility / Account <br /> Account Name {� J� v-C a a . S C S e e CO&G 1 (Circle One) <br /> Account Balance as of 8/5/2010: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inachm <br /> Program/Element and Description Record ID Employee ID and Name Status Nev,Owner? Delete <br /> 2960-RWQCB SITE PRO506203 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 andfor Federal Laws. <br /> APPLICANTS 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 Received by <br /> REHS: Date / / Account out: Mr-- Date / S /NO <br /> COMMENTS: <br /> \\eh-env\envisiontreports\5021.rpt <br />