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Date run 7/26/2004 4:01:26PK SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> ,,,so` Facility Information as of 7/2612` <br /> Record Selection Criteria: Facility ID FA0007060 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0004047 New Owner ID <br /> Owner Name THE WINE GROUP LLC <br /> Owner DBA THE WINE GROUP LLC- FRANZIA <br /> Owner Address 17000 E HWY 120 <br /> RIPON, CA 95366 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-599-4111 <br /> Mailing Address 17000 E HWY 120 <br /> RIPON, CA 95366 <br /> Care of MONICA CARABAJAL <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0007060 <br /> Facility Name THE WINE GROUP <br /> Location 17000 E HWY 120 <br /> RIPON, CA 95366 <br /> Phone 209-599-4111 <br /> Mailing Address DO BOX 897 <br /> RIPON, CA 95366 <br /> Care of MONICA CARABAJAL <br /> Location Code 99 - UNINCORPORATED AREA APN: <br /> BOS District 005- ORNELLAS, LEROY SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0010199 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility I Account <br /> Account Name THEWINEGROUP (circle one) <br /> Account Balance as of 7/26/2004: $0.00 <br /> (Circle One) <br /> —� <br /> Transfer o ActivellnacNe <br /> Program/Element and Description D Status Stas New Owner? Delete <br /> 2960-RWQCB CLEAN UP SITE(SLIC) 111111 ���.../// _ ��`� Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,th id/or project specific.PHSIEHO hourly charges associated with this <br /> facility or activity will be billed to the party identifietl as the O ,}�I - (�C {� 0 y �� rdance with all applicable Ortlinace Codes and/or Standards and <br /> State andlor Federal Laws, I V\ > I`.�/—gyp <br /> APPLICANT'S SIGNATURE: CC2 `Q 1 r e <br /> Program Records to be TRANSFEREjNu <br /> n S S L) 5 Cj` late <br /> Water System to be TRANSFERED: `\ to <br /> Payment Type Cby <br /> REHS Date <br /> COMMENTS: <br /> \\Phs-ehsgl-nt\apps\Envisions\Reports\5021.rpt <br />