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Date ran 3/13/2003 10:50:03AI SAN JOAF V COUNTY ENVIRONMENTAL HEALTT- FPARTMENT Report#5021 <br /> Run by ' Pagel <br /> i 03 <br /> Facility Information as of 3/13/20 <br /> Record Selection Criteria: Facility ID FA0009208 <br /> D�D Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0007208 Case Number: H02050 New Owner ID <br /> Owner Name RAYMOND INVESTMENT CORP <br /> Owner DBA RAYMOND AGRICULTURAL WHSE <br /> Owner Address <br /> Home Phone Not Specified <br /> WorkBusinessPhone 209-466-8664 � "'^2 <br /> Mailing Address P.O. BOX 567 <br /> STOCKTON, CA 95201 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009208 <br /> Facility Name RAYMOND AGRICULTURAL WHSE <br /> Location 2245 W CHARTER WAY <br /> STOCKTON, CA 95206 <br /> Phone 209-466-3077 <br /> Mailing Address P.O. BOX 567 <br /> STOCKTON, CA 95201 <br /> Care of <br /> Location Code 01 -STOCKTON APN:163-360-17 <br /> BOS District 001 -GUTIERREZ, STEVE SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016208 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name RAYMOND INVESTMENT CARP (Circle one) <br /> Account Balance as of 3/13/2003: $90 / ;U a;&-& @ �E� (Circle One) <br /> Transfer to gctive/IrecNe <br /> Program,Elemem and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2220-SM HW GEN<5 TONSNR PR0513700 EE0008844-DINA ABATE Active Y N AD <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PR0511496 EE0000000-HAZ MAT SJC DES Active Y N A D <br /> 2244-PACT TRANSFER RECORD-DES PR0519461 Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE FPR0509208 EEo000000-HAZ MAT SJC DES Inactive 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/EHO hourly charges associated with this <br /> facility or activity will be billed to the party identified as the OWNER on this form. I also candy that all operations will be performed in accordance with as applicable Ordinate Codes and/or Standards and <br /> State and/or Federal Laws. <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid <br /> Water System to be TRANSFERED: '$155.00= Amount Paid to <br /> Payment Type Check Number y <br /> REHS: Date / / Account out: t?! ate / /—,p <br /> COMMENTS: <br /> \\Phs-ehsgl-nt\apps\Envisions\Reports\5021.rpt <br />