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fate run `. 3/11/2002 3:11:38PW SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 3/11/2002 <br /> Record Selection Criteria: Facility ID FA0003940 <br /> Make changes/corrections In RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner IDX-8801 <br /> 13 New Owner ID <br /> Owner NameR&C PANY F flL <br /> Owner DBAIR& OMPANY <br /> Owner Address15 <br /> CA 95201 505 err 87J �5� 'Per <br /> Home Phonefie <br /> Work/Business Phone801Mailing Address1529N, CA�52019D�/-S3a 9 <br /> Care of P E CHAIR&COMPANY <br /> FACILITY FILE INFORMATION <br /> Facility I <br /> Facility Namee P P E E OH <br /> CHAIRIR <br /> &COMPANY� ) <br /> Location 1102 S AURORA ST nn <br /> STOCKTON, CA 95206 <br /> Phone 209-948-8801 /%/✓Q / �ift�rxar�p r� wG <br /> Mailing Address 1102 AUR ST �3(Z�if�Mt 4 4dR �/L L �UU <br /> STOC O CA 95205 f)a,,9-� , Cu, 15�a a/ <br /> Care of PE OHA &COMPANY <br /> Location Code 01 -ST C ON APN: <br /> BOS District 001 UTIE EZ, STEVE SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0003548 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name p E CHAIR&COMPANY OO (circle one) <br /> Account Balance as of 3/11/2002: $0.00 b�WU DO / c�8 <br /> (CiOne) <br /> Transfer to ActNe/ie/InacNe <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2381 -UST FACILITY(BEFORE 1/84) PR0231015 EE0000008-LETITIA BRIGGS Inactive 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 parry identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinace Codes andtor Standards and <br /> State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date / / <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: '$150.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br /> \\Phs-ehsql-nt\apps\Envisions\Reports\5021.rpt <br />