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rRec.ord <br /> n - 4/2512.008 8:27:27Ah SAN JC UIN COUNTY ENVIRONMENTAL HEA 1 DEPARTMENT Report#5021 <br /> -+..I <br /> Facility Information as of 4/25/2008 Page1 <br /> Selection Criteria: Facility ID FAD005302 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNER FILE INFORMATION OWNERSHIP CHANGE(date) <br /> Owner ID OW0003473 New Owner ID <br /> Owner Name SPRECKELS SUGAR CO <br /> Owner DBA SPRECKELS SUGAR COMPANY <br /> Owner Address 20500 HOLLY G:� <br /> TRACY, CA 953041649 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-835-3210 <br /> Mailing Address PO BOX 60 <br /> TRACY, CA 95378 <br /> Care of <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility ID FA0005302 <br /> Facility Name SPRECKELS SUGAR COMPANY <br /> Location 20500 HOLLY DR <br /> TRACY, CA 95304 <br /> Phone 209-835-3210 <br /> Mailing Address PO BOX 60 <br /> TRACY, CA 95378 <br /> Care of <br /> Location Code 03 -TRACY APN: <br /> BOS District 005 -ORNELLAS, LEROY SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0005764 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner ! Facility / Account <br /> Account Name SPRECKELS SUGAR COMPANY (Circle One) <br /> Account Balance as of 412512008: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inacive <br /> Program/Element and Description Record to Employee ID and Name Status New Owner? Delete <br /> 2220-SM HW GEN <5 TONSIYR PR0513793 EE0005642-MICHELLE HENRY Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO511655 EEOOOOOOO-HAZ MAT SJC OES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-OES PR0519583 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0502021 EE0005642-MICHELLE HENRY Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARPR0507590 EE0000451 -STEVE SASSON Inactive Y N A D <br /> 2836-AST FAC>I=100 M+I GAL CUMULATIVE PR0515794 EE0005642-MICHELLE HENRY Active Y N A D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific,PHSIEH❑hourly charges associal d with this <br /> facility 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 Ordinace Codes and/or Stan ands and <br /> State andlor Federal Laws. <br /> APPLICANT'S SIGNATURE: Date I I <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date / 1 <br /> Water System to be TRANSFERED: '$372.00= Amount Paid Date I I <br /> Payment Type Check Number Recei d y <br /> REHS: Date I I Account out: Date l�l <br /> COMMENTS: <br /> Ilphs-ehsgl-ntlappslenvisionslreports15021.rpt <br />