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Date run 5/11/01 1:53:07PM SAI`*AQUIN COUNTY PUBLIC HEALTH SEWES Report u: 0002 <br /> Run by Facility Information as of 5/11/01 Page u: 1 <br /> Record Selection Criteria: Facility ID FA0004083 <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: OW0003001 New Ownnerl ID <br /> Owner Name. 19100RIT, 0 1 ANLET� <br /> Owner DBA: RE MANUFACTURING INC <br /> Owner Address: PO BOX 8098 <br /> STOCKTON, CA 95208- <br /> Home Phone: 209-943-1981 <br /> Work/Bussness Phone: 209-943-1981 <br /> Mailing Address: PO BOX 8098 <br /> STOCKTON, CA 95208- <br /> Care of: MOORE, STANLEY <br /> FACILITY FILE INFORMATION <br /> Facility ID: FA0004083 <br /> Facility Name: RE MANUFACTURING INC <br /> Location: 1825 E CHARTER WAY <br /> STOCKTON, CA 95208 <br /> Phone: 209-943-1981 <br /> Mailing Address: PO BOX 8098 <br /> STOCKTON, CA 95208- <br /> care of: REMANUFACTURING/9'1d5e+4E / f n/ <br /> Location Code: 01 - STOCKTON APN; y ' <br /> BOS District: SIC Code; <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID: AR0003743 * A New Account ID:: <br /> Mail Invoices to--1750711 / Mail Invoices to: Owner/Facility/Account <br /> Account Name: RE MANUFACTURING INC (Circle One) <br /> Account Balance as of 5/11/01: $0.00 <br /> (Circle One) <br /> UST(s) Transferto Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status inked New Owner? Delete <br /> 2960-RWQCB CLEAN UP SITE PR0009048 EE0000684-INFURNA Active N I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific, <br /> PHS/EHD hourly charges associated with this facility or activity will be billed to the party identified as the BILLING PARTY on this form. I also certify that all <br /> operations will be performed in accordance with all applicable Ordinace Codes and/or Standards and State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date / / <br /> Program Records to be TRANSFERED: '$0.00= Amount Paid Date / I <br /> Water System a TRANSF ED: '$150.00= Amount Paid Date�/ 1'? /0 p� <br /> Payment a Check Number jSf' Receipt Number Received,b --�Df—�7,T <br /> REHS: �� Date=LA <br /> / Account out: Date <br /> 1.0.0.89.00 • • <br />