Laserfiche WebLink
Date run 2/5/2013 3:55:10PM SAN JC JIN COUNTY ENVIRONMENTAL HEA I DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 2/5/2013 <br /> Record Selection Criteria: Facility ID FA0018700 <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 OW0008071 Case Number: H06440 New Owner ID <br /> Owner Name RIPON FARM SERVICES <br /> Owner DBA RIPON FARM SERVICE <br /> Owner Address 938 S HWY 99 E FRONTAGE RD <br /> RIPON, CA 953660806 <br /> Home Phone 209-476-8213 <br /> Work/Business Phone 209-599-2188 <br /> Mailing Address PO BOX 806 <br /> RIPON, CA 953660806 <br /> Care of OUDEN, BUD DEN <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility ID FA0018700 <br /> Facility Name RIPON FARM SERVICES <br /> Location 932 FRONTAGE RD <br /> RIPON, CA 95366 <br /> Phone 209-599-2188 <br /> Mailing Address 938 FRONTAGE RD <br /> RIPON, CA 95366 <br /> Care of <br /> Location Code 99- UNINCORPORATED,8 Alt Phone <br /> BOS District 005 -ORNELLAS, LEROY Fax <br /> APN 26102011 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone 209-599-2188 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0033183 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name R F LAND (Circle One) <br /> Account Balance as of 2/5/2013: $-375.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2965-WATER QUALITY SITE PROJECT PR0527598 EE0001459-VICKI MCCARTNEY Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andlor project specific,PHS/EHD hourly charges associated with this facility <br /> 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 Ordinance Codes andlor Standards and State andlor <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: `$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br />