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oaten lo 4/30/2007 3:09:37PR SAN JO*N COUNTY ENVIRONMENTAL HEAVDEPARTMENT Report#5021 <br /> r Run byPagel <br /> Facility Information as of 4/30/200 <br /> Record Selection Criteria: Facility ID FA0012793 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner I OW0009967 New Owner ID <br /> Owner Name STUDLEY COMPANY <br /> Owner DBA MUSCO OLIVE PRODUCTS INC <br /> Owner Address 17950 W VIA NICOLO <br /> TRACY, CA 95377 <br /> Home Phone 209-836-4600 <br /> Work/Business Phone Not Specified <br /> Mailing Address 17950 W VIA NICOLO <br /> TRACY, CA 95377 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0012793 <br /> Facility Name MUSCO OLIVE PRODUCTS INC <br /> Location 17950 W VIA NICOLO <br /> TRACY, CA 95377 <br /> Phone 209-836-4600 <br /> Mailing Address 17950 W VIA NICOLO <br /> TRACY, CA 95377 <br /> Care of BEN HALL <br /> Location Code 99- UNINCORPORATED AREA APN 20911032 <br /> BOS District 005 -ORNELLAS, LEROY SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION e/ <br /> Account ID AR0021419 0 New Account ID: <br /> Mail Invoices to Account J� Mail Invoices to: Owner / Facility / Account <br /> Account Name MUSCO FAMILY OLIVE COU <br /> C (Circle One) <br /> Account Balance as of 4/30/2007: $0.00 �p \ \� J� <br /> (Give/i One) <br /> Transfer to gctive/Inactve <br /> Program/Element and Description ortl ID Em ogee ID and Name Status New Owes? Delete <br /> 2965-WATER QUALITY SITE PROJECT PRO516772 E0000684-MICHAEL INFURNA Active Y N A I D. <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the un ersigned own , pemtor or agent of same,acknowledge that all site,and/or project specific,PHS/EHD hourly charges associated wth this <br /> facility or activity will be billed to the party identified as the OWNE ortn. I also certify that all operations will be performed in accordance with all applicable Ordinace Codes andlor 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: _*$372.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br /> \\phs-ehsql-nt\apps\envisions\reports\5021.rpt <br />