Laserfiche WebLink
Repo"%5021 <br /> Date run 5/23/2007 12:10:10PI SAN JOAQUIN COUNTY ENVIRONMENTAL HEA H DEPARTMENT Pagel <br /> Run by Facility Information as of 5/23/2007 <br /> Record Selection Criteria: Fauliry ID FA0016241 <br /> Make changes/corrections in RED Ink or pencil. <br /> INFORMATION CHANGE(date) <br /> EJU IE OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> New Owner ID <br /> Owner ID OW0001176 <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 DORAbO ST <br /> STOCKTON, CA 95202 <br /> Care of CITY OF STOCKTON <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016241 LJ0.T <br /> Facility Name <br /> Location 2500 NAVY DR Lp/10 <br /> STOCKTON, CA 95206 q3 2 'g 7 63 <br /> Phone 209�8740r— <br /> Mailing Address 2500 NAVY DRfs-_ <br /> STOCKTON, CA 95206 <br /> Care of fi r I / 7I� <br /> Location Code 01 -STOCKTON APN:16333003 rA vna.t� 1k11(l �c S <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 / acility' Account <br /> Account Name <br /> Account Balance as of 5/23/2007: J$-48R.-ff_ S�b7 (Iajj_ik (Circle One) <br /> Transferto Actme/Inactve <br /> New Owner? Delete <br /> PrograMElement and Description Record ID Employee ID and Name Status <br /> 2965-WATER QUALITY SITE PROJECT PRO524190 EE0009488- /GREY -- . A�ctive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of sam ac nR ow AN. al(all si et 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 Ordinate Codes and/or Standards and <br /> State andlor Federal Laws. <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: "$20.00= Amount Paidas •GD Data <br /> Water System to be TRANSFERED: '$372.00= Amount Paid Date <br /> Payment Type Check Number b g Re ved by t\\ (r <br /> RENS: a^''� Date / / Accountout Date_/_/_ <br /> COMMENTS: <br />