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Date run 3/28/2003 2:25:OOPK SAN JOAN COUNTY ENVIRONMENTAL HEALIVEPARTMENT Report #5021 <br />Runty D Pagel <br />Facility Information as of 3/28/200,, <br />Record Selection Criteria: Facility ID FA0006982 <br />OWNER FILE INFORMATION <br />Owner ID <br />OW0005738 <br />Owner Name <br />APPLIED AEROSPACE STRUCTURES <br />Owner DBA <br />APPLIED AEROSPACE STRUCTURES C <br />Owner Address <br />3437 S AIRPORT WAY <br />Phone <br />STOCKTON, CA 95206 <br />Home Phone <br />Not Specified <br />Work/Business Phone <br />901-763-1434 <br />Mailing Address P.O. BOX 6189 <br />STOCKTON, CA 952060189 <br />Care of <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0006982 <br />Facility Name <br />APPLIED AEROSPACE STRUCTURES C <br />Location <br />3437 S AIRPORT WAY <br />STOCKTON, CA 95206 <br />Phone <br />209-983-3216 <br />Mailing Address 3437 S AIRPORT WAY <br />STOCKTON, CA 95206 <br />Care of .JERRY OSTRANDER, GEN MANAGER <br />Location Code 01 -STOCKTON <br />BOS District 001 - GUTIERREZ, STEVE <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Make changes/corrections in RED ink or pencil. <br />INFORMATION CHANGE (date) <br />OWNERSHIP CHANGE (date) <br />New Owner ID : <br />APN: <br />SIC Code: <br />Account ID AR0009987 New Account ID: : <br />Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br />Account Name Q' (�A?b d N SRtls t-Nct- �'i �- (Circle One) <br />Account Balance as of 3/28/2003: $0.00 G� U <br />f/tl Gf G� (Circle One) <br />v � Transfer to Active/Inactve <br />Program/Element and Description Record ID Employee ID and Name Status <br />�3 Status New Owner? Delete <br />2960 - RWQCB CLEAN UP SITE (SLIC) PRO505763 EE0000756 - CAROL OZ 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: <br />Program Records to be TRANSFERED: ' $20.00 = <br />Water System to be TRANSFERED: ' $155.00 = _ <br />Payment Type Check Number <br />REHS: <br />COMMENTS: <br />\\Phs-e hsq I-nt\apps\Envisions\Reports\5021. rpt <br />Date <br />Date <br />Amount Paid Date <br />Amount Paid Date-, <br />Recei d <br />Account out: Date _ /�_ ) <br />