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Date run 7/21/2020 11:45:10At SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 7/21/2020 <br /> Record Selection Criteria: Facility ID FA0025628 <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 OW0024285 New Owner ID <br /> Owner Name UNION PACIFIC RAILROAD COMPANY <br /> Owner DBA <br /> OwnerAddress 1408 MIDDLE HARBOR RD <br /> OAKLAND, CA 94607 <br /> Work/Business Phone Not Specified <br /> Alternative Phone Not Specified <br /> Mailing Address 1408 MIDDLE HARBOR RD <br /> OAKLAND, CA 94607 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0025628 <br /> Facility Name STOCKTON CA JAN 27, 2017 LOCOMOTIVE <br /> Location 833 E EIGHTH ST <br /> STOCKTON, CA 95206 <br /> Phone <br /> Mailing Address 1408 MIDDLE HARBOR RD <br /> OAKLAND, CA 94607 <br /> Care of <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOS District Fax <br /> APN 16901009 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0048442 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name ARCADIS US INC (Circle One) <br /> Account Balance as of 7/21/2020: 1714.40 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2950-ENVIRON ASSESS PR0545044 EE0009488-JEFFREY WONG 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 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 andror Standards and State anc/or <br /> Federal Laws. <br /> V— <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: *$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type Check Number Received by <br /> EHD Staff: Date / / Account out: Date <br /> COMMENTS: <br /> Invoice#: <br /> V <br />