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Date run 7/27/2004 8:46:10AN SAN JUIN COUNTY ENVIRONMENTAL HEf H DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 7/27/2 04 <br /> Record Selection Criteria: Facility ID FA0009525 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0007525 Case Number: H04754 New Owner ID <br /> Owner Name AIR PRODUCTS ENERGY ENTERPRISE <br /> Owner DBA STOCKTON COGEN CO INC <br /> Owner Address <br /> Home Phone Not Specified <br /> Work/Business Phone 209-983-0391 <br /> Mailing Address 1010 ZEPHYR ST <br /> STOCKTON, CA 95206 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009525 <br /> Facility Name STOCKTON COGEN CO INC <br /> Location 1010 ZEPHYR ST <br /> STOCKTON, CA 95206 <br /> Phone 209-983-0391 <br /> Mailing Address 1010 ZEPHYR ST <br /> STOCKTON, CA 95206 <br /> Care of <br /> Location Code APN:177-280-13 12 <br /> BOS District SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016525 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name STOCKTON COGEN CO INC (Circle One) <br /> Account Balance as of 7/27/2004: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> New Owner? Delete <br /> Program/Element and Description Record ID Employee ID and Name Status <br /> 2214-CalARP FAC STATE SURCHARGE FEE PRO519001 EE0000451 -STEVE SASSON Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR0513884 EE0008844-DINA ABATE Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PR0511813 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2226-CalARP PROGRAM PRO514609 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2244-PACT TRANSFER RECORD-OES PRO520967 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE FPR0509525 EE0000000-HAZ MAT SJC OES Inactive 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 party 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: '$155.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br /> \\Phs-ehsgl-nt\apps\Envisions\Reports\5021.rpt <br />