Laserfiche WebLink
Date run 7/15/2008 12:56:35PI SAN JOAl1UIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br />Run by Pagel <br />Facility Information as of 7/15/2008 <br />Record Selection Criteria: Facility ID FA0010475 <br />OWNER FILE INFORMATION <br />Owner ID <br />OW0008475 Case Number: H08176 <br />Owner Name <br />FEDEX FREIGHT WEST <br />Owner DBA <br />FEDEX FREIGHT WEST <br />Owner Address <br />6411 GUADALUPE MINES RD <br />209-466-2127 <br />SAN JOSE, CA 95120 <br />Home Phone <br />Not Specified. <br />Work/Business Phone <br />408-323-4561 <br />Mailing Address <br />6411 GUADALUPE MINES RD #2185 <br />Y <br />SAN JOSE, CA 95120 <br />Care of <br />I D <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0010475 <br />Facility Name <br />FEDEX FREIGHT WEST <br />Location <br />4520 S HWY 99 <br />I D <br />STOCKTON, CA 952158235 <br />Phone <br />209-466-2127 <br />Mailing Address 6411 GUADALUPE MINES RD #2185 <br />SAN JOSE, CA 95120 <br />Care of <br />Location Code <br />BOS District <br />APN 179-200-34 <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name <br />Title <br />Day Phone <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Make changes/corrections in RED ink or pencil. <br />INFORMATION CHANGE (date) <br />OWNERSHIP CHANGE (date) <br />SSN / Fed Tax ID <br />New Owner ID : <br />Alt Phone <br />Fax <br />EMail : <br />Account ID AR0017475 New Account ID: <br />Mail Invoices to Facility Mail Invoices to: Owner / <br />Account Name FEDEX FREIGHT WEST <br />Account Balance as of /15/2008: $0.00 <br />Program/Element and Description Record ID Employee ID and Name Status <br />Facility / Account <br />(Circle One) <br />(Circle One) <br />Transfer to Active/Inactve <br />New Owner? Delete <br />2220 - SM HW GEN <5 TONS/YR PRO514342 <br />EE0008317 - RAYMOND VON FLUE <br />Active <br />Y <br />N <br />A <br />I D <br />2224 - HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512763 <br />EE0000000 - HAZ MAT SJC OES <br />Inactive <br />Y <br />N <br />A <br />I D <br />2244 - PACT TRANSFER RECORD - OES PRO520372 <br />EE0000000 - HAZ MAT SJC OES <br />Active <br />Y <br />N <br />A <br />I D <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARPR0510475 <br />EE0000000 - HAZ MAT SJC OES <br />Inactive <br />Y <br />N <br />A <br />I D <br />— PR0523291 <br />EE0008317 - RAYMOND VON FLUE <br />Active <br />Y <br />N <br />A <br />I C � <br />740 - WASTE TIRE SITE - EXEMPT PR0524070 <br />EE5555555 - Garrett Alias -Backus <br />Inactive <br />Y <br />N <br />A <br />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 <br />hourly charges <br />associated with this <br />facility or activity will be billed to the party identified as the OWNER on this form. I also <br />certify that all operations will be performed in accordance with all applicable Ordinace Codes and/or Standards <br />and <br />State and/or Federal Laws. <br />APPLICANT'S SIGNATURE: <br />Date <br />Program Records to be TRANSFERED: <br />Water System to be TRANSFERED: <br />Payment Type Check Number <br />REHS: <br />COMMENTS: <br />\\phs-ehsgl-nt\apps\envisions\reports\5021.rpt <br />* $20.00 = <br />* $372.00 = <br />Date 1 /. <br />Amount Paid Date <br />Amount Paid Date <br />Receivq <br />Account out:L Date / &a <br />