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BILLING
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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TOM PAINE
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18775
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2300 - Underground Storage Tank Program
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PR0503170
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BILLING
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Entry Properties
Last modified
1/2/2021 10:08:01 PM
Creation date
11/6/2018 10:18:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
RECORD_ID
PR0503170
PE
2332
FACILITY_ID
FA0004052
FACILITY_NAME
FARM UGT
STREET_NUMBER
18775
Direction
S
STREET_NAME
TOM PAINE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
21302030
CURRENT_STATUS
02
SITE_LOCATION
18775 S TOM PAINE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\TOM PAINE\18775\PR0503170\BILLING .PDF
QuestysFileName
BILLING
QuestysRecordDate
10/20/2017 9:25:04 PM
QuestysRecordID
3693629
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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IRA 1bpr-tS A151M -----SAM NPUMFMFElA SERV39ESof 09/09/ <br /> -------------------- <br /> Make changes/corrections in RED pen - penci <br /> OWNER FILE INFORMATION Date of IFFORMRTION CHANGE:, <br /> d v,Z7a Date of OWNERSHIP CHANGE: <br /> ODER ID:--00a9-7New Omer ID: 00 — <br /> Owner Name: SIE Y PRODUCTION CREDITcrita�u_— <br /> Owner DBA: SiORAPAY PCA PROPERTY �, — <br /> Owner Address: 8070 p , �2 Z ` <br /> aTOCK-MN, CA 95208 � -- <br /> Hose Phone. 209---.9-6-1-3770 . Ga/7 <br /> Work/Business Phone: 201-3770 <br /> ti <br /> Mailing Address: PO PDX 807 <br /> Care of: ELIOT ETON <br /> ST TON, CA 95208 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 004052 �) <br /> Facility Name: SIERRA P P'CA P'ROP'ERTY U' G- <br /> Location: 18775 S TOM PAINE RD <br /> TRACY 95376 <br /> Phone: 209-990 �Kro µle+ Q <br /> � s <br /> Mailing Address: P'OPDX 8 0 _ <br /> Care of: ELIOT 'PLETON <br /> STO TON, CA 95208 <br /> Location Code: 03 APN: 213-020-30-8 <br /> BOS District: 03 SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> R1D; 0003700 New Account ID: 00 <br /> Mail Invoices <br /> to; Fac 0&77l� Mail Invoices to: EFET/7 Facility <br /> Account Name: SIERRA PAY PCA PROPERTY <br /> Account Balance as of 09/09/94 $ 0. 00 <br /> FILES LINKED: No WATER SYSTEM FILE linked <br /> Record LIST(s) Transfer to Activate / Inactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> ----------------------------------------------------- ------------------------- <br /> 2951 UBT-CRP PR004367 0684 INFURNA ACTIVE N A 1 D <br /> 2332 EXEMPT TANG( FACILITY PR583170 0142 SNAVELY INACTIVE I Y N A I D <br /> -------------------------------------------------------------------------------- <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site and/or <br /> project specific PHS/EHD hourly charges associated with this facility or activity will be billed to the party identified as the <br /> BILLING PARTY on this form. I also certify that all operations will be performed in accordance with all applicable SAN JOAQUIN <br /> COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. <br /> APPLICANTS SIGNATURE• Date / /9 <br /> ---------_--------------------------------------------------- <br /> Programs to be TRANSFERED: x $20.00 - Amount Paid Date —/—/9— <br /> Payment <br /> / /9_Payment Type Check 1 Recyd by <br /> ------------- ---- — — — —,—r --------- ------- ---- ---------------- <br /> RENS or COUNTER SUPV:--- —.--Date/ /9 f- ACCT out: `� 'Date �✓ /-1/9 UNIT/File:_/_/9— <br />
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