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Date run 4/29/2008 2:47:00PI\ SAN JO, IN COUNTY ENVIRONMENTAL HEAL DEPARTMENT Report#5021 <br />Run by Pagel <br />Facility Information as of 4/29/2008 <br />Record Selection Criteria: Facility ID FA0012350 <br />OWNER FILE INFORMATION <br />Owner ID OW0007223 Case Number: H02193 <br />Owner Name BOGETTI'S ORCHARD INC <br />Owner DBA <br />Owner Address <br />Home Phone Not Specified <br />Work/Business Phone 209-835-8972 <br />Mailing Address PO BOX 705 <br />VERNALIS, CA 95385 <br />Care of BOGETTI, ALBERT <br />FACILITY FILE INFORMATION <br />Facility ID FA0012350 <br />Facility Name–$pGETTI'S" <br />Location -2-,r� <br />VERNALIS, CA <br />385 <br />Make changes/corrections in RED ink or pencil. <br />INFORMATION CHANGE (date) <br />OWNERSHIP CHANGE (date) <br />New Owner ID : <br />Phone / <br />Mailing Address PO BOX 705 <br />VERNALIS, CA 95385 <br />Care of ALBERT BOGETTI <br />Location Code 99 - UNINCORPORATED AREA APN: <br />BOS District 005 - ORNELLAS, LEROY SIC Code: <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0020179 <br />Mail Invoices to Owner <br />Account Name BOGETTI'S ORCHARD INC <br />Account Balance as of 4/29/2008: $0.00 <br />Program/Element and Description <br />Record ID <br />New Account ID: <br />Mail Invoices to: Owner / Facility / Account <br />(Circle One) <br />(Circle One) <br />Transfer to Active/Inactve <br />Employee ID and Name Status New Owner? Delete <br />2836 -AST FAC >/=100 M + 1 GAL CUMULATIVE PR0515779 EE0000001 - LINDA TURKATTE Active Y N AD <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 associal 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 Stand rds and <br />Slate 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 />RENS: <br />COMMENTS: <br />\\p hs-ehsq I-nt\apps\envisions\reports\5021. rpt <br />Date <br />$20.00 = Amount Paid Date <br />$372.00 = Amount Paid Date <br />Date / / Account out: k— Date <br />