Laserfiche WebLink
Date run 4/24/2008 2:27:13PN SAN '11N COUNTY ENVIRONMENTAL HE ? DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 4/24/20015 <br /> Record Selection Criteria: Facility ID FA0012336 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0009568 New Owner ID <br /> Owner Name WEST SIDE IRRIGATION DIST <br /> Owner DBA <br /> Owner Address 20100 S WICKL/;i,D <br /> TRACY, CA 95376 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-835-0523 <br /> Mailing Address PO BOX 177 <br /> TRACY, CA 95376 <br /> Care of THE WEST SIDE IRRIGATION DIST <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0012336 <br /> Facility Name WEST SIDE IRRIGATION DISTRICT <br /> Location 20100 S WICKLUND <br /> TRACY, CA 95376 <br /> Phone 209-835-0523 <br /> Mailing Address PO BOX 177 <br /> TRACY, CA 95376 <br /> Care of THE WEST SIDE IRRIGATION DIST <br /> Location Code 99 - UNINCORPORATED AREA APN: <br /> BOS District 005 - ORNELLAS, LEROY SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0020151 NewAccount ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name WEST SIDE IRRIGATION DIST (Circle One) <br /> Account Balance as of 4/24/2008: $0.00 <br /> (Circle One) <br /> Transfer to <br /> Active/lnactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> -AST FAC>/=100 M+ 1 GAL CUMULATIVE PR0515761 EE0000001 -LINDA TURKATTE Active Y N J 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 as th 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 Ordinate Codes and/or Standards and <br /> State and/or Federal Laws. <br /> -P'�e;?—1�1'6 1 <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: `$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: '$372.00= Amount Paid Date <br /> Payment Type Check Number Recei <br /> REHS: Date / / Account out: Date /_� /0 <br /> COMMENTS: <br /> ti: ii'llit <br /> 1110, <br /> �/l�✓!�S � I L% 'gar �k c IIP <br /> \\phs-ehsql-nt\apps\envisions\reports\5021.rpt <br />