Laserfiche WebLink
Date run 12/6/2021 9:21:05AN SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br />Run by Pagel <br />Facility Information as of 12/6/2021 <br />Record Selection Criteria: Facility ID FA0023096 <br />OWNER FILE INFORMATION Number of facilities for this owner : 1 <br />Owner ID <br />OW0021189 <br />Owner Name <br />STATE OF CALIFORNIA - CDCR <br />Owner DBA <br />DEUEL VOCATIONAL INSTITUTE (DVI) <br />OwnerAddress <br />2555 EL PORTAL DR <br />SAN PABLO, CA 94806 <br />Work/Business Phone <br />Not Specified <br />Alternative Phone <br />510-412-5820 <br />Mailing Address <br />2555 EL PORTAL DR <br />SAN PABLO, CA 94806 <br />Care of <br />FACILITY FILE INFORMATION APN 23912001 <br />Facility ID / CERS ID FA0023096 <br />Facility Name DEUEL VOCATIONAL INSTITUTE (DVI) <br />Location 23500 KASSON RD <br />TRACY, CA 95304 <br />Phone 209-835-4141 <br />Mailing Address 23500 KASSON RD <br />TRACY, CA 95304 <br />Care of <br />of 3r1:III IFTTelil:101Vt'Je,%1[01:1 <br />Contact Name <br />Title <br />Day Phone <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0042413 <br />Mail Invoices to Account n <br />Account Name AMEC FOSTER WHEELER 1 <br />Email invoice to (up to 2 emails) <br />Email permit to (up to 2 emails) <br />Account Balance as of 12/6/202: $-260.00 <br />Make changes/corrections in RED ink. <br />INFORMATION CHANGE (date) <br />OWNERSHIP CHANGE (date) <br />SSN / Fed Tax ID <br />New Owner ID : <br />New Account ID: : <br />Mail Invoices to: Owner / Facility / Account <br />(Circle One) <br />(Circle One) <br />Transfer to Activ ve <br />Program/Element and Description Record ID Employee ID and Name Status New Owner? to <br />2950 - ENVIRON ASSESS PR0540419 EE0006219 - LORI DUNCAN Active Y N A D <br />2965 - RWQCB LEAD AGENCY WASTE DISCHARGE SIT PR0541181 EE0001453 - NUEL HENDERSON Active Y N A I- D <br />BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that ite, and/or 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 c ify that all operations will b performed in ac rdance with all applicable Ordinance Codes and/or Standards and State and/or <br />Federal Laws. <br />APPLICANT'S SIGNATURE: Date _/ 21 <br />Program Records to be TRANSFE D: $ .00 = Amount Pal <br />Date <br />Water System to be TRANSFEREI Date <br />Payment Type Check Number Received b <br />EHD Staff: Date / ! Account out: Date <br />COMMENTS: <br />If1VOICe #: <br />