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Date run 12/16/2021 11:47:47f SAN 2UIN COUNTY ENVIRONMENTAL HE H DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 12/16/2021 <br /> Record Selection Criteria: Facility ID FA0000031 <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 OW0000024 New Owner ID <br /> Owner Name BOGGIANO FAMILY INTEREST <br /> Owner DBA LINDEN ORCHARDS LC#54 <br /> OwnerAddress 22261 E STOLTE RD <br /> LINDEN, CA 95236 <br /> Work/Business Phone Not Specified <br /> Alternative Phone 209-931-3086 <br /> Mailing Address 7 8_0Q AI QE nnooTlnn l nI <br /> LINDEN, GA n5236 <br /> Care of BOGGIANO, J & M <br /> FACILITY FILE INFORMATION APN 06518004 j <br /> Facility ID/CERS ID FA0000031 <br /> Facility Name LINDEN ORCHARDS 39-54 ` <br /> Location 21100 E FRAZIER RD <br /> LINDEN, CA 95236 <br /> Phone 209-931-2568 <br /> Mailing Address 8077 N TULLY RD <br /> LINDEN, CA 95236 <br /> Care of ADO &SON <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name JOSE GARCIA <br /> Title <br /> Day Phone 209-931-3086 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0000031 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name LINDEN ORCHARDS 39-54 (Circle One) <br /> Email invoice to(up to 2 emails) <br /> Email permit to(up to 2 emails) <br /> Account Balance as of 12/16/2021: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2765-EMPLOYEE HOUSING-PERMANENT>180 DAYS PR0270054 EE0003611 -FRANK GIRARDI Active Y N A I D <br /> 4634-TNC WATER SYSTEM(QRTLY) PR0542790 EE0000036-NAVJOT SAHOTA Inactive Y N A I D <br /> 4617-EMPLOYEE HOUSING-WATER SUPPLY WA0515762 EE0003611 -FRANK GIRARDI Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,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 certify that all operations will be performed in accordance with all applicable Ordinance Codes and/or Standards and State and/or <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 />