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Date run 5/23/2006 11:09:33AI SAN JOIN COUNTY ENVIRONMENTAL HEA DEPARTMENT Repo usozf 1 <br /> Run by Pagel <br /> Facility Information as of 5/23/20 <br /> Record Selection Criteria: Facility ID FA0010390 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0008390 Case Number: H07982 New Owner 1D : <br /> Owner Name SCHNEIDER NATIONAL INC <br /> Owner DBA SCHNEIDER NATIONAL INC <br /> Owner Address 161 E TRANSPORTATION CT <br /> FRENCH CAMP, CA 95231 <br /> Home Phone 209-234-4002 <br /> Work/Business Phone 800-616-3984 <br /> Mailing Address PO BOX 2500 <br /> GREEN BAY, WI 54306 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010390 <br /> Facility Name SCHNEIDER NATIONAL INC <br /> Location 161 E TRANSPORTATION CT <br /> FRENCH CAMP, CA 95231 <br /> Phone 209-982-9690 <br /> Mailing Address 161 E TRANSPORTATION CT <br /> FRENCH CAMP, CA 95231 <br /> Care of <br /> Location Code 99 - UNINCORPORATED AREA APN 19327018 <br /> BOS District 001 -GUTIERREZ, STEVE SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> AccountlD AR0017390 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner I Facility / Account <br /> Account Name SCHNEIDER NATIONAL INC (Circle One) <br /> Account Balance as of 5/23/2006: $1,253.50 <br /> (Circle One) <br /> Transfer to Activelinactve <br /> Program/Element and Description Record 1D Employee ID and Name Status New OwneR Delete <br /> 2220-SM HW GEN<5 TONSNR PRO514306 EE0008389-DENNIS CATANYAG Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512678 EE0000000-HAZ MAT SJC GES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-GES PR0520366 EE0000000-HAZ MAT SJC GES Active Y N A I D <br /> 2390-ABOVEGROUND TANK(SPCC) PR0516178 EE0008389-DENNIS CATANYAG Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARrPR0510390 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 4232-ALTERNATIVE/ENGINEERED SEPTIC SYS/PR0522468 EE0009374-LARRY GODINHO Active Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523537 EE0004636-GARRETT BACKUS Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge[hal 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 Ordinates Codes and/or Standards and <br /> Stale and/or Federal Laws. <br /> APPLICANTS 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 />