Laserfiche WebLink
Date run : 11/3/00 2:26:35PM SANQUIN COUNTY PUBLIC HEALTH SE ES Report #: 0002 <br /> jiun by': VDAVIS & Facility Information as of 11/3/00 ` Page #. 1 <br /> Record Selection Criteria: Facility ID FA0010624 <br /> Record ID <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE (date) <br /> OWNERSHIP CHANGE (date) <br /> OWNER FILE INFORMATION <br /> Owner ID: OW0008624 Case Number: H08428 New Owner ID <br /> Owner Name: AGRIUM US INC <br /> Owner DBA' <br /> Owner Address: X39 <br /> P,AIdJ—�- 39 <br /> Home Phone: Not Specified <br /> Work/Bussness Phone: 403-258-4600 <br /> Mailing Address: PO BOX 239 <br /> PAUL, ID 83347-0239 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID: FA0010624 <br /> Facility Name: AGRIUM US INC ,{— <br /> Location: 2201 W WASHINGTON ST 10 �CA, <br /> STOCKTON, CA 95203 (� <br /> Phone: 209-546-1740 r <br /> Mailing Address: 410-B0X-2�39 <br /> CA L(--A 'i, ��'fI r CA NR D 9 <br /> Care of: S M THOMAS <br /> Location Code: 01 -STOCKTON APN: 145-020-04-6 <br /> BOS District: 001 - GUTIERREZ, STEVE SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION 6PO1sI (�L:9 <br /> AccountlD: AR0017624 S IILv t New Account ID:: <br /> Mail Invoices to: Account 1 1 �� (�` Mail Invoices to: Owner/ Facility/Account <br /> Account Name: AGRIUM USINC )� E� l�O"` (Circle One) <br /> Account Balance as of 11/3/00: $10.00 ��j �� 57�/ <br /> DC l (Circle One <br /> UST(s) Transfer to Active/Inacty <br /> Program/Element and Description Record ID Employee ID and Name Status Linked New Owner? Delete <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE F PR0510624 EE0000000-SJC DES Active Y N 1 <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PR0512912 EE0000000-SJC OES Active Y N I <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT. /,the undersigned owner,operator or agent ojsame,acknowledgge that all site,and/or project <br /> specific,PHS/EHD hourly charges associated with this jncility or activity will be billed to lite party idend red as the B/LL/NG PARTYon thisform. I <br /> also certify that all operations will be performed in accordance with all applicable Ordini ce Codes nn or Stan dards and State aaUor Federal Laws <br /> APPLICANT'S SIGNATURE: Date I / <br /> Program Records to be TRANSFERED: '$0.00= Amount Paid Date <br /> Water System to be TRANSFERED: '$150.00= Amount Paid Date / / <br /> Payment Type Check Number Receipt Number Received by <br /> RENS: Date / / Account out: Date <br /> o- o � tsi �rr.1� <br /> 1.0.0.89.00 <br />