Laserfiche WebLink
Date run 8/28/01 11:20:46AM SA*QUIN COUNTY PUBLIC HEALTH SEFW' S Report #: 5023 <br /> Run by s Facility Information as of,8/28/01 Page #. 1 <br /> Record Selection Criteria: Facility ID FA0007439 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID: OW0002972 New Owner ID <br /> Owner Name: SPRECKLES DEVELOPMENT CO INC <br /> Owner DBA: <br /> Owner Address: 18800 SPRECKLES RD <br /> MANTECA, CA 95336 <br /> Home Phone: 209-823-3121 <br /> Work/Business Phone: 209-823-3121 <br /> Mailing Address: 18800 SPRECKLES RD <br /> MANTECA, CA 95336 <br /> Care of: JEFFREY FLEMING <br /> FACILITY FILE INFORMATION <br /> Facility ID: FA0007439 <br /> Facility Name: SPRECKELS SUGAR PLANT#2 <br /> Location: 18800 SPRECKELS RD <br /> MANTECA, CA 95336 <br /> Phone: 209-823-3121 <br /> Mailing Address: 140 JOHN JAMES AUDUBON PKWY <br /> AMHERST, NY 142281112 <br /> Care of: BOB GREEN <br /> Location Code: 04- MANTECA APN: <br /> BOS District: SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> AccoumID: AR0011323 New Account ID: <br /> Maillnvoicesto: Facility Mail Invoices to: Owner/Facility/Account <br /> Account Name: SPRECKELS SUGAR PLANT#2 (circle one) <br /> Account Balance as of 8/28/01: $0.00 <br /> (Circle One) <br /> Transfer to Aclive/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2950-ENVI RON ASSESS PR0506459 EE0007479-RON ROWE Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific,PHS/EHD hourly charges associated with this <br /> facility or activity will be billed to the parry identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinace Codes and/or Standards and <br /> State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date / ! <br /> Water System to be TRANSFERED: `$150.00= Amount Paid Date / / <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br /> \\Phs-ehsq I-nt\apps\Envisions\Reports\5021.rpt <br />