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Date run 1 6/112020 3:53:16PN SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by M OZUNA Pagel <br /> Facility Information as of 6/11/2020 <br /> Record Selection Criteria: Facility ID FA0024634 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 1 SSN/Fed Tax ID <br /> Owner ID OW0023239 New Owner ID <br /> Owner Name MOTLEY, RHEA& BRIAN <br /> Owner DBA SNOWIE NORCAL <br /> OwnerAddress 94 W AMENO LN <br /> MOUNTAIN HOUSE, CA 95391 <br /> Work/Business Phone Not Specified <br /> Alternative Phone 650-868-0715 <br /> Mailing Address 94 W AMENO LN <br /> MOUNTAIN HOUSE, CA 95391 <br /> Care of MOTLEY, RHEA <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0024634 <br /> Facility Name SNOWIE NORCAL <br /> Location 385 ENTERPRISE PL <br /> TRACY, CA 95304 <br /> Phone 650-868-0715 <br /> Mailing Address 94 W AMENO LN <br /> MOUNTAIN HOUSE, CA 95391 <br /> Care of MOTLEY, RHEA <br /> Location Code 03-TRACY Alt Phone <br /> BOS District Fax <br /> APN EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name MOTLEY, RHEA PAYMENT <br /> Title RECEIVED <br /> Day Phone 650-868-0715 <br /> Night Phone JUN Y020 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0046045 SAN JOAQUIN COUNTY NewAccount ID: <br /> ENVIRONMENTAL <br /> Mail Invoices to Facility HEALTH DEPARTMENT Mail Invoices to: Owner / Facility / Account <br /> Account Name SNOWIE NORCAL (Circle One) <br /> Account Balance as of 6/11/2020: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1633-FOOD VEHICLE/CART(LTD FOOD PREP) PR0543378 EE0004589-KADEANNE LINHARES Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andfor 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 and/or Standards and Slate and/or <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: Date / ! <br /> Program Records to be TRANSFERED: `$25.00= Amount Paid Date <br /> Water System to be RANSFERED: Amount Paid 0- Date 1,1 240 <br /> Payment Type Check Number !/()!7627 Received b <br /> EHD Staff: Date / ! Account out: 44LDate _/ `1 2-0 <br /> 33 <br /> COMMENTS: Invoice#: 16.2. <br /> ,-D'T <br />