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Date run 7/29/2003 10:44:28AI SAN JOIN COUNTY ENVIRONMENTAL HE DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 7/29/2003 <br /> Record Selection Criteria: Facility ID FA0007479 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0006182 New Owner ID <br /> Owner Name WEBER, HARRY <br /> Owner DBA CAIN ELECTRIC WORKS <br /> Owner Address 230 N CHURCH ST <br /> LODI, CA 95240 <br /> Home Phone 209-369-9536 <br /> Work/Business Phone Not Specified <br /> Mailing Address 230 N CHURCH ST <br /> LODI, CA 95240 <br /> Care of HARRY WEBER <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0007479 <br /> Facility Name CAIN ELECTRIC WORKS <br /> Location 230 N CHURCH ST <br /> LODI, CA 95240 <br /> Phone 209-369-9536 <br /> Mailing Address 230 N CHURCH ST <br /> LODI, CA 95240 <br /> Care of HARRY WEBER <br /> Location Code 02 - LODI APN: <br /> BOS District 004-SEIGLOCK, JACK SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0011613 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name CAIN ELECTRIC WORKS (Circle One) <br /> Account Balance as of 7/29/2003: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> New Owner? Delete <br /> Program/Element and Description Record ID Employee ID and Name Status <br /> 2959-NON NPUSEP HZ SITE PRO506532 EE0000249-MARY MEAYS Active 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 party identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinace Codes and/or 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: *$155.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> RENS: Date / / Account out: Date <br /> COMMENTS: <br /> \\Phs-ehsql-nt\apps\Envisions\Reports\5021.rpt <br />