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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0523822
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
6/30/2020 2:50:23 PM
Creation date
6/30/2020 2:18:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0523822
PE
2965
FACILITY_ID
FA0016043
FACILITY_NAME
WOODBRIDGE WINERY/ ROBERT MONDAVI
STREET_NUMBER
5950
Direction
E
STREET_NAME
WOODBRIDGE
STREET_TYPE
RD
City
ACAMPO
Zip
95258
APN
01709058
CURRENT_STATUS
01
SITE_LOCATION
5950 E WOODBRIDGE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Date run 12/15/2008 4:15:09P SAN JOAnt NTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run bwe y <br /> Facility Information as of 12115/2( Pagel <br /> Record Selection Criteria. Facility ID FA0016043 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0003358 New Owner ID <br /> Owner Name R M E INC <br /> Owner DBA WOODBRIDGE WINERY <br /> Owner Address PO BOX 1260 <br /> WOODBRIDGE, CA 95258 <br /> Home Phone 209-369-5861 <br /> Work/Business Phone 209-365-8081 s. <br /> Mailing Address PO BOX 1260 �� _• <br /> WOODBRIDGE, CA 95258 <br /> Care of JIM CRANDELL <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016043 <br /> Facility Name WOODBRIDGE WINERY/ ROBERT MONDA\ <br /> Location 5950 E WOODBRIDGE RD <br /> ACAMPO, CA 95258 <br /> Phone 209-369-5861 <br /> Mailing Address PO BOX 1260 <br /> WOODBRIDGE, CA 95258 <br /> Care of <br /> Location Code 99- UNINCORPORATED A Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> APN 01709058 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name MONDAVI, ROBERT <br /> Title <br /> Day Phone 209-369-5861 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0027975 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name KENNEDY/JENKSCONSULTANTS (Circle One) <br /> Account Balance as of 12/15/200 : 50 a <br /> S e C � �, ` _SS (Circle One) <br /> U�1"�- Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2965-WATER QUALITY SITE PROJECT PR0523822 EE0000997-HARLIN KNOLL Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andlor 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: �Pe.. 0.� 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 /> RENS: Date_/ / Account out: lZk� Date <br /> COMMENTS: <br /> \\phs-ehsq e-nt\apps\envisions\reports\5021.rpt <br />
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