Laserfiche WebLink
Datarun 11/2012007 8:48:46A SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report usort <br /> Run by %4006 <br /> O <br /> Facility Information as of 11/20/2007 Pagel <br /> Record Selection Criteria: Facility ID FA0013309 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) — <br /> OWNER FILE INFORMATION OWNERSHIP CHANGE(date) _— <br /> Owner ID OW0010450 <br /> Owner Name GENERAL DYNAMICS OTS (CA) INC New Owner ID <br /> Owner DBA <br /> Owner Address 400 ESTUDILLO AVE <br /> SAN LEANDRO, CA 94577 <br /> Home Phone 510-614-5360 <br /> Work/Business Phone Not Specified <br /> Mailing Address 400 ESTUDILLO AVE <br /> Care of SAN LEANDRO, CA 94577 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0013309 <br /> Facility Name TRACY TEST FACILITY <br /> Location 32727 CORRAL HOLLOW RD <br /> TRACY, CA 95376 <br /> Phone <br /> Mailing Address PO BOX 5@38 <br /> Care of NICEVILLE, FL 32578— P D 60 K &325 gg <br /> Location Code <br /> BOS District 005-ORNELLAS, LEROY AP25112004 <br /> SIC Code: <br /> ACCOUNTS ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0022111 <br /> Mail Invoices to Facility New Account ID: <br /> Account Name TRACY TEST FACILITY Mail Invoices to: Owner / Facility / Account <br /> Account Balance as of 11/20/2007: $0.00 (Circle One) <br /> Program/Element and Description Transfer to (Cimle One) <br /> Record ID Employee ID and NameNew Owner? Active/Inactve <br /> 2959-DTSC- HW SITE status Delete <br /> PRO517291 EE000099I -HARLIN KNOLL Active <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(his <br /> state or activity will be Gilled 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 /> Stats and/or Federal Laws. �1� <br /> APPLICANT + <br /> S SIGNATURE: r-rA-cN-Eb <br /> DateA-111-/—n <br /> Program Records to be TRANSFERED: •$20.00= <br /> Water System to be TRANSFERED: Amount Paid Date <br /> '$372.00= Amount Paid Date <br /> Payment Type Check Number <br /> RENS: Received by <br /> Date <br /> COMMENTS _/ /_ Account out: _ ALL Date <br /> : <br /> \\phs-ehsql-nt\apps\envisions\reports\5021.rpt <br />