Laserfiche WebLink
Date run 7/2/2008 2:21:52PM SAN J" AN COUNTY ENVIRONMENTAL HF 'DEPARTMENT Report#5021 <br />Run by Pagel <br />Facility Information as of 7/2/2u08 <br />Record Selection Criteria: Facility ID FA0004071 <br />Make changes/corrections in RED ink or pencil. <br />INFORMATION CHANGE (date) <br />OWNERSHIP CHANGE (date) <br />OWNER FILE INFORMATION SSN / Fed Tax ID : <br />Owner ID OW0002851 <br />Owner Name LLOW T <br />Owner DBA YELLOW TRANSPORTATION (TCY) <br />Owner Address 1'6199TIR�5E AVE <br />OVERLC07 <br />Home Phone Not Specified <br />Work/Business Phone 913-344-3000 <br />Mailing Address <br />213 <br />Care of <br />FACILITY FILE INFORMATION <br />Site Mitigation Facility <br />Facility ID <br />FA0004071 <br />Facility Name <br />Location <br />9 —41 <br />A 95205 <br />Phone <br />209-948-1510 <br />Mailing Address <br />I r—ox—=o <br />KA 66207 <br />Care of <br />OT <br />Location Code <br />99 - UNINCORPORATED P Alt Phone <br />BOS District <br />002 - RUHSTALLER, LARRY Fax Ci <br />APN <br />34 �S Entail : 7! <br />EMERGENCY NOTIFICATION <br />CONOTACT INFORMATIO <br />Contact Nam <br />CA <br />Title <br />Day Phone <br />209-43 L f 6 <br />Night Phone <br />209 - <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID <br />AR0003728 New Account ID: <br />Mail Invoices to <br />Facility Mail Invoices to: Owner ! <br />Account Name <br />Account Balance as of 7/2/2008: $0.00�,l , ,n <br />' l <br />/ 1'L0� <br />and Description <br />Record ID Employee ID and Name <br />Status <br />Facility / Account <br />(Circle One) <br />(Circle One) <br />Transfer to Active/Inaclve <br />New Owner? Delete <br />2381 - UST FACILITY (BEFORE 1/84) - obsolete PR0231611 EE0000008 - LETITIA BRIGGS Inactive Y N A D <br />390 - ABOVEGROUND TANK (SPCC) — PR0515710 EE0000008 - LETITIA BRIGGS Inactive Y N (!S i D <br />2950 - ENVIRON ASSESS--- PR0001611 EE0000963 - DIANE HINSON 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, PHS/EHD hourly charges assoc +ith 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 StE s and <br />State and/or Federal Laws, <br />APPLICANT'S SIGNATURE: <br />Program Records to be TRANSFERED: <br />Water System to be TRANSFERED: <br />Payment Type Check Number <br />REHS: <br />COMMENTS: <br />\\phs-ehsql-nt\apps\envisions\reports\5021. rpt <br />$20.00 = Amount Paid <br />' $372.00 = Amount Paid - <br />Date / / Account out: <br />Date <br />Date <br />Date <br />Receive <br />%� Date / / <br />