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Runby : STAFF San Joaquin County PHS/EHD Report #5021 <br /> FACILITY INFORMATION as of 09/27/95 <br /> ------------------------------------------------------------------------------- <br /> Make changes/corrections in RED pen or pencil: <br /> OWNER FILE INFORMATION INFORMATION CHANGE (date) : <br /> OWNERSHIP CHANGE (date) : <br /> OWNER ID: 002669 New Owner ID: 0 0 <br /> Owner Name: AMERICAN SAVINGS BANK <br /> Owner DBA: AMERICAN SAVINGS BANK <br /> owner Address: 400 E MAIN ST 4TH FLOOR <br /> STOCKTON, CA 95290 <br /> Home Phone: 209-546-2434 <br /> Work/Business Phone: 209-983-4099 <br /> Mailing Address: 400 E MAIN ST 4TH FLOOR <br /> care of: AMERICAN SAVINGS BANK <br /> STOCKTON, CA 95206 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 004093 <br /> Facility Name: AMERICAN SAVINGS BANK <br /> Location: 222 N EL DORADO ST <br /> STOCKTON 95202 <br /> Phone: 209-546-2434 <br /> Mailing Address: 17875 VON KARMON STE 200 <br /> Care of: CRC ENVIRONMENTAL RISK MGMT <br /> IRVINE, CA 92714 <br /> Location Code: 01 APN: 139-100-19-2 <br /> BOS District: SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT ID: 0003753 New Account ID: 000 <br /> Mail Invoices to: Account - Mail Invoices to: Owner / Facility / Account <br /> Account Name: CRC ENVIRONMENTAL RISK MGMT (Circle one) <br /> Account Balance as of 0 9/2 7/9 5 : $382 . 20 (Circle one) <br /> Record UST(s) Transfer to Activate / Inactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> --=---------------------------------------------------------------------------- <br /> 2953 LCL HW CLEANUP SITE PR009146 0684 INFURNA ACTIVE Y N A I D <br /> ------------------------------------------------------------------------------- <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site and/or <br /> project specific PHS/EHD hourly charges associated with this facility or activity will be billed to the party identified as the <br /> BILLING PARTY on this form. I also certify that all operations will be performed in accordance with all applicable SAN JOAQUIN <br /> COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> ------------------------------------------------------------------------------- <br /> PR Records to be TRANSFERED: x $20.00 - Amount Paid Date. <br /> Water System to be TRANSFERED: x $150.00 = Amount Paid Date <br /> Payment Type Check # Recvd by <br /> REHS or COUNTER SUPV: Date—/—/ ACCT out: Date—/—/— UNIT/File: / / <br />