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Date run 7/11/2022 11:34:15AP SAN JOA N COUNTY ENVIRONMENTAL HEALT ')EPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 7/11/2021 <br /> Record Selection Criteria: Facility ID FA0001464 <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 OW0001144 New Owner ID <br /> Owner Name GOGNA, DENNIS <br /> Owner DBA GOGNA, VERNON <br /> OwnerAddress 13959 E FANNING RD <br /> STOCKTON, CA 95215 <br /> Work/Business Phone 209-603-0011 <br /> Alternative Phone Not Specified <br /> Mailing Address 13797 E FANNING RD <br /> STOCKTON, CA 95215 <br /> Care of GOGNA, VERNON <br /> FACILITY FILE INFORMATION APN 09105008 <br /> Facility ID/CERS ID FA0001464 10180753 <br /> Facility Name GOGNA, VERNON 39-176 <br /> Location 13959 E FANNING RD <br /> STOCKTON, CA 95215 <br /> Phone 209-931-4392 x <br /> Mailing Address 13797 E FANNING RD <br /> STOCKTON, CA 95215 <br /> Care of GOGNA, DENNIS <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name GOGNA, VERNON <br /> Title <br /> Day Phone 209-931-4392 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0001463 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name GOGNA, VERNON 39-176 (Circle One) <br /> Email invoice to(up to 2 emails) KRISH@OGPACKING.COM; DENGOGNA@/ <br /> Email permit to(up to 2 emails) DENGOGNA@AOL.COM <br /> Account Balance as of 7/11/2022: $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 /> 1958-HM-Farm Operations 1 chem units PR0525875 EE9999998-ONE VACANT1 Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR0530720 EE9999998-ONE VACANTI Active Y N A I D <br /> 2755-EMPLOYEE HOUSING-SEASONAL<180 DAYS PR0270176 EE0003611 -FRANK GIRARDI Inactive Y N (T) I D <br /> 2830-AST FAC -SPCC EXEMPT PR0530719 EE0000027-CINDY VO Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE PR0531866 Inactive Y N A I D <br /> 4617-EMPLOYEE HOUSING-WATER SUPPLY WA0515737 EE0002089-OMRAN SOOD 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 andror <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 �ckumber Received by <br /> EHD Staff: Date T Account out: Date / / <br /> COMMENTS: <br /> Invoice#: <br />