Laserfiche WebLink
Lepodp5021 <br /> Date mo 5/23/2007 12:10:10PI SAN JOAQUIN COUNTY ENVIRONMENTAL HEAL I DEPARTMENT Pagel <br /> Ranby Facility Information as of 5/23/2007 <br /> Record Selection Criteria: Facaiy ID FA0016241 <br /> Make changes/corrections in RED ink or pencil. <br /> ___. INFORMATION CHANGE(date) <br /> =—■`• !� OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION —_�� <br /> Owner I OW0001176 New Owner ID <br /> Owner Name CITY OF STOCKTON <br /> Owner DBA <br /> Owner Address 425 N EL DORADO ST <br /> STOCKTON, CA 95202 <br /> Home Phone Not Specified <br /> work/Business Phone 209-937-8377 <br /> Mailing Address 425 N EL DOWO ST <br /> STOCKTON, CA 95202 <br /> Care of CITY OF STOCKTON <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016241 c 't <br /> Facility Name Wq, <br /> Location 2500 NAVY DR Lp/V�ro <br /> STOCKTON, CA 95206 '73 -7 — <br /> Phone 209-957--87#0r— <br /> mailing Address <br /> 09 g37- 8T#0r— <br /> MailingAddress 2500 NAVY DRF--' <br /> STOCKTON, CA 95206 <br /> Care of r l <br /> Location Code 01 - STOCKTON APN16333003 yYWYItG� G({r�t//� <br /> BOS District 001 - GUTIERREZ, STEVE SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0028404 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner I acility' Account <br /> Account Name I <br /> Account Balance as of 5/23/2007: $-1 b7 (I/ltsC (CirdeOne) <br /> Transfer to ActNa/Inadve <br /> Record ID Employee ID and Name Status New Owneh Delete <br /> Program/Elemant entl Description <br /> 2965-WATER QUALITY SITE PROJECT PRO524190 EE0009488- Active Y N A I D <br /> ��,Wj� r <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acKnoxlcfdge at 1dX si e,and/or project specific,PHB/EHD hoary charge associated with lois <br /> facility or activity will be billed to the parry identified as the OWNER on this form. I also certify that all operations w01 be performed in accordance with all applicable Ordmaoe Codes and/or Standards and <br /> Stale antler Federal Laws. <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid S• Date <br /> Water System to be TRANSFERED: '$372.00= Amount Paid Date <br /> Payment Type Check Number 3 fJ g Re vad by <br /> REHS: —r• '^�'�'�`��'�r'� Date a /Aa Account out: Date <br /> �/ <br /> COMMENTS: <br />