Laserfiche WebLink
Date run 9/1/2010 4:10:23PM SAN J( UIN COUNTY ENVIRONMENTAL HEA I 19M DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 9/1/20 <br /> Record Selection Criteria: Facilitv!D FA0009941 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0007941 Case Number: H05938 New Owner ID <br /> Owner Name RON OR LYLE GOEHRING <br /> Owner DBA GOEHRING PUMP & IRRIGATION <br /> Owner Address 17754 N HWY 88 <br /> LOCKEFORD, CA 95237 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-727-5548 <br /> Mailing Address PO BOX 113 <br /> LOCKEFORD, CA 95237 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009941 <br /> Facility Name GOEHRING PUMP& IRRIGATION <br /> Location 17754 N HWY 88 <br /> LOCKEFORD, CA 95237 <br /> Phone 209-727-5548 <br /> Mailing Address PO BOX 113 <br /> LOCKEFORD, CA 95237 <br /> Care of <br /> Location Code 99- UNINCORPORATED A Alt Phone <br /> BOS District 004-VOGEL, KEN Fax <br /> APN 051-250-10 EMail: G W1 • -� urn . <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016941 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name RON OR LYLE GOEHRING (Circle One) <br /> Account Balance as of 9/1/2010: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2220-SM HW GEN<5 TONS/YR PR0514103 EE0001422-ARIS CACAPIT Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512229 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-OES PR0519976 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2333-FARM UST#1 FACILITY-obsolete PRO501799 EE0004636-GARRETT BACKUS Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARPR0509941 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING SURCHARGE PRO531999 Active Y N A 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 hourly charges associated 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 Standards and <br /> State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type Check Number Received b <br /> REHS: 12 Date `1 / / lD Account out: Date <br /> COMMENTS: <br /> \\eh-env\envision\reports\5021.rpt <br />