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" ;m0111111 <br /> Run by ?BORASan Joaquin County PHS EHD <br /> Re <br /> -- FACILII NFORMATION :s of 10/ 13/9E P <br /> rt 45021 <br /> — -------------- <br /> --------------- — <br /> ------ _o — <br /> Make changes/corrections in P,ED pen o; pencil: <br /> OWNER FILE INFORMATION INFORMATION CHANGE (date): <br /> OWNERSHIP CHANGE (date): <br /> OWNER ID: 004278 New Owner ID: 00 <br /> Owner Name: UfNION OIL OF CALIFORNIA <br /> Owner DBA: UNOCAL BULK PLANT #0788 <br /> Owner Address: 1201 W FIFTH ST <br /> LOS ANGELES , CA 90017 <br /> Home Phone: <br /> Soc Sect I Tax IDt: <br /> Ownership Type: 01 CORPORATION <br /> Mailing Address: PO BOX 5155 <br /> Care of: PENNY <br /> SAN RAMON , CA 94583 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 005437 <br /> Facility Name: UNOCAL BULK PLANT #0788 <br /> Location: .8203 W 11TH ST <br /> TRACY 95375 <br /> Phone: <br /> Mailing Address: PO BOX 5 15 5 <br /> Care of: PENNY <br /> SAN RAMON , CA 94583 <br /> location Code: 03 APN: 250-140-03 <br /> DOS District: 005 SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT I0: 0005905 Neu Account IO: 000 <br /> Mail Invoices to: Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name: UNION OIL OF CALIFORNIA (Circle one) <br /> Account Balance as of 10/13/98 : $78 . 00 (Circle one) <br /> Record $78 . 00 <br /> Transfer to Activate f Tr.activata <br /> P/E Description to Employee Status linked new owner? Delete <br /> -------------------------------------- <br /> ------------------------------ <br /> 2953 LCL HW CLEANUP SITE PR502410 6219 DUNCAN 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 PHSjEHO 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 _f / <br /> ----------------_------------------------ <br /> --------------------- -- <br /> PR Records to be TRANSFEAED: x ;20.00 Amount Paid Date/ / <br /> Water System to be TRANSFERED: x $150.00 = Amount Paid Date_/ / <br /> Payment Type Check I Recvd by <br /> --------------------------------------------------- _ <br /> ------------------------- <br /> REHS or COUNTER SUPV: Date_/_/_ ACCT out: Date_/_;_ UNITIFile:_/_f_ <br />