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Run by . STAFF SAN J04 ) COUNTY PUBLIC 14EALTH SERVICES <br /> INFORMATION as of 08/0-1/94 <br /> OWNER FILE INFORMATION Make changes/correct ions in RED pen or nencil. <br /> Date of INFORVATION CHANGE- <br /> Date of OWNEERSHIP CHANGE: <br /> 01E R ID. 003007 New Mier IN 00 <br /> Owner Nace.- WESTREC PROPERTIES INC <br /> Owner DBA.- TOWER PARK MARINA <br /> DAneroddres: 6400 LAUREL- CANYON BLVD <br /> N HOLLYWOOD, CA 91606 — <br /> Hone Phone- 818-753-0400 <br /> Work/Business Phone: 209-369-1041 <br /> MailinDAddres: 6400 LAUREL CANYON BLVD <br />� <br /> Care of <br /> '- m HOLLYWOOD, CA 91606 <br /> FACILITY FILE INFORMATION � -----� <br /> FACILITY ID. 004091 <br /> Facility Name: TOWER PARK MARINA ` <br /> Location: 14900 W HWY 12 ! <br /> LODI 95242 <br /> Phone: 209-369-1041 <br /> Mailing Address: 4000 TER DR #305 <br /> Care o .'' ^ <br /> .'f: LAW MENTAL INC <br />� � <br /> SAN RA�)EL, CA 94903 <br /> Location Code: 02 APN: / <br /> ' | <br /> BOS District: 02 SD: Code: <br />� <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT ID: 0003751 ' New Account IN 000 <br /> Mail Invoices to: Owner Nai1 Invoices to: Owner <br /> Account Name.- WESTREC PROPERTIES INC - <br />� <br /> Account Balance as of 08/05/94 : $ 0. 00 <br /> FILES LINKED:LINKED: No WATER SYSTEM FILE linked <br /> Record , UST(s) Transfer to Activate / Inactivate <br />� P/E Description ID Employee Status Linked new owner? Delete <br /> 2960 NWQCD CLEAN UP SITE PRU9023 0684 [NFURNA ACTIVE Y N l D <br /> ------------------------------------____________________________________________ , <br /> 8ILLlNG and COMPLIANCE : Is the undersigned owner, operator or agent of save, acknowledge that all site and/or <br /> project specific PHS/B0 hourly charg»s associated with this facility or activity will be hi}}e0 to the party identified as the <br />� <br /> BILLING PARTY on this form. l also certify that all operations will be performed in accordance with all applicable SAN JDAQU[N <br /> COUNTY Ordinance Codes and/or Standards and State and/or Federal Laos. <br /> APPLICANT'S SIGNATURE, Date| <br /> Programs to be TRANSFERED: x $20.00 Amount Paid Date <br /> Payment Type Check # Recvd by <br /> REHS or COUNTER SUPI, Date ACCT out Date UNIT/File: <br />{ <br />