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Run by : DOUGW SAN A COUNTY PUBLIC HEALTH SERVICES Report— -------- #5021 FACILITY INFORMATION as of 10/31/94 it ------ ----- ----------------------------- -- — ------------------------- OWNER FILE INFORMATION Make changes/corrections in RED pen or pencit: Date of INFORMATION CHANGE:__ Date of OWNERSHIP CHANGE: OWNER ID: 002052 New Owner ID: 00 Owner Name: NEWARK SIERRA PAPERBOARD CORP owner DBA: NEWARK SIERRA PAPERBOARD CORP Owner Address: 800 W CHURCH STOCKTON, CA 95203 Home Phone: work/Business Phone: Mailing Address: 800 W CHURCH Care of: NEWARK SIERRA PAPERBOARD CORP STOCKTON, CA 95203 FACILITY FILE INFORMATION FACILITY ID: 002715 Facility Name: NEWARK SIERRA PAPERBOARD CORP Location: 800 W CHURCH STOCKTON 95203 Phone: Mailing Address: 800 W CHURCH care of: NEWARK SIERRA PAPERBOARD CORP STOCKTON, CA 95203 Location Code: 01 APN: SOS District: 01 SIC Code: ACCOUNTS RECEIVABLE FILE INFORMATION ACCOUNT ID: 0004498 New Account ID: 000 Mail Invoices to: Facility Mail Invoices to: Owner / Facility Account Name: NEWARK SIERRA PAPERBOARD CORP Account Balance as of 10/31/94 : $ 0. 00 FILES LINKED: No NATER SYSTEM FILE linked Record UST(s) Transfer to Activate / Inactivate P/E Description ID Employee Status Linked new owner? Delete _____________________ 2381 UST FACILITY (BEFORE 1/84) PR231063 9903 WILSON ACTIVE 3 ! N 4! E 5<25 TONS .25 !G• 5o PR220074 0988 FOLEY ACTIVE Y N A 1 D BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1, the undersigned owner, operator or agent of same, acknowledge that all site and/or project specific PHS/EHD hourly charges associated with this facility or activity will be billed to the party identified as the BILLING PARTY on this form. 1 also certify that all operations will be performed in accordance with all applicable SAN JOAQUIN COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. APPLICANT'S SIGNATURE: —/ / Date 9 ---------------------------- ------------------------------- Programs to be TRANSFERED: x $20.00 = Amount Paid Payment Type Date -----------------------------------------------Check Recvd by _________________ REHS or COUNTER SUPV: Date—/—/9— ACCT out: Date—/_/9_ UNIT/File:_/_/9_ z yy 4 3 7 s, e J