Laserfiche WebLink
Date run 7/21/2020 10:27:26AI 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 FA0024683 <br /> Make changestcorrections 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 OW0023291 New Owner ID <br /> Owner Name AMB RANCH MANAGEMENT <br /> Owner DBA AMB AG ENTERPRISE <br /> OwnerAddress 28806 AVE 15 <br /> MADERA, CA 93638 <br /> Work/Business Phone Not Specified <br /> Alternative Phone 559-674-5400 <br /> Mailing Address 28806 AVE 15 <br /> MADERA, CA 93638 <br /> Care of TRUJILLO, ELI <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS la FA0024683 <br /> Facility Name AMB AG ENTERPRISE <br /> Location 28806 AVE 15 RD <br /> MADERA, CA 95638 <br /> Phone 559-674-5400 <br /> Mailing Address 28806 AVE 15 RD <br /> MADERA, CA 95638 <br /> Care of NAVARRO, MARIAN <br /> Location Code 98 -OUT OF COUNTY Alt Phone <br /> BOS District Fax <br /> APN EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name Hernandez,Abigail <br /> Title <br /> Day Phone 559-674-5400 <br /> Night Phone 559-363-9042 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0046188 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name AMB AG ENTERPRISE (Circle One) <br /> Account Balance as of 7/21/2020: $368.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID a ame S tus New Owner? Delete <br /> 4244-PUMPER TRUCK PR0543484 EE00094 JEFFREY WON?G Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowl that all site,anrYo 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. 1 also certify that all operations will be performed in ce with all applicable Ordinance Codes andfor Standards and State andlor <br /> Federal Laws. <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 />