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Run by : LAURIEB SaJoaquin County PHS/EHD Report #5021 <br /> FACILITY INFORMATION as of 09/08/99 <br /> ------------------------------------------------------------------------------- <br /> Make changes/corrections in RED pen or pencil: <br /> OWNER FILE INFORMATION INFORMATION CHANGE (date) : <br /> OWNERSHIP CHANGE (date): <br /> OWNER ID: 002955 New owner ID: 00 <br /> owner Name: LINCOLN PROPERTIES LTD �inADlri eP -Cr n✓ ern Aflm-Tr�sF - <br /> Owner DBA: <br /> Owner Address: 615 LINCOLN CENTER <br /> STOCKTON, CA 95207 <br /> Home Phone: 209-478-9200 <br /> Sac Sec# / Tax ID#: <br /> Ownership Type: 09 UNKNOWN <br /> Mailing Address: 615 LINCOLN CENTER <br /> Care of: WILBUR SMITH <br /> STOCKTON, CA 95207 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 007271 I //�• ��ti <br /> Facility Name: SETTLING DRY CLEANERS DEFENDAN { nUl n 1 � a &W 9o�WLiM TI JSi <br /> Location: PACIFIC/BENJAMIN HOLT AVE <br /> STOCKTON 95207 <br /> Phone: 415-951-1100 610 — 237 <br /> Mailing Address: 1 EMBARCADERO CENTER <br /> Care of: ROBERT THOMPSON ' rICAAanLs <br /> SAN FRANCISCO, CA 94111 i nn6( Ntqqy� <br /> Location Code: 01 APN: gl8/9G <br /> BOS District: 002 SIC Code: �hl�u eft #Qm <br /> ACCOUNTS RECEIVABLE FILE INFORMATION -7YkAk g <br /> ACCOUNT ID: 0 010 7 3 6 New Account ID: 000 <br /> Mail Invoices to: Account Mail Invoices to: Owner / Facility / -Account <br /> Account Name: LeBOEUF ET AL/BOB THOMPSON (Circle one) <br /> Account Balance as of 09/08/99 : $1, 474 .20 (Circle one) <br /> Record UST(s) Transfer to Activate / Inactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> ------------------------------------------------------------------------------- <br /> 2960 RWQCB CLEAN UP SITE PR506203 0684 INFURNA 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-F== <br /> Payment Type Check # Recvd by <br /> ----------------------------------------------- ------------------------------- <br /> REPS or COUNTER SUPV: Date_/_/_ ACCT out: L6 Date Q"// / UNIT/File: <br />