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Ranby : STAFF San Joaquin County PHS/EHD Report #5021 <br /> FACILITY INFORMATION as of 10/24/97 <br /> ------------------------------------------------------------------------------- <br /> Make changes/corrections in RED pen or pencil: <br /> OWNER FILE INFORMATION INFORMATION CHANGE (date) : <br /> OWNERSHIP CHANGE (date) : <br /> OWNER ID: 003000 New Owner ID: 00 <br /> Owner Name: U S CHEMICAL COMPANY <br /> Owner DHA: U S CHEMICAL COMPANY <br /> Owner Address: 1448 SHAW RD <br /> STOCKTON, CA 95215 <br /> Home Phone: <br /> Soc Sec# / Tax ID#: <br /> Ownership Type: 09 UNKNOWN <br /> Mailing Address: 1448 SHAW RD <br /> Care of: U S CHEMICAL COMPANY <br /> STOCKTON, CA 95215 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 004082 <br /> Facility Name: U S CHEMICAL COMPANY <br /> Location: 1448 SHAW RD <br /> STOCKTON 95215 <br /> Phone: 209-948-3035 <br /> Mailing Address: 1448 SHAW RD <br /> Care of: USC/HYDRITE CHEMICAL DIV <br /> STOCKTON, CA 95215 <br /> Location Code: 0 1 APN: <br /> BOS District: SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT ID: 0003742 New Account ID: 000 <br /> Mail Invoices to: Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name: U S CHEMICAL COMPANY (Circle one) <br /> Account Balance as of 10/24/97 : $0 . 00 (Circle one) <br /> Record UST(s) Transfer to Activate / Inactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> ------------------------------------------------------------------------------- <br /> 2960 RWQCB CLEAN UP SITE PR009096 0684 INFURNA INACTIVE Y N A I D <br /> 2229 GEN 50<250 TONS PERMIT PR505375 0606 TREVENA INACTIVE Y N A I D <br /> 2232 HAZARDOUS WASTE CA FACILITY PE PR506997 0606 TREVENA ACTIVE Y N A I D <br /> 2212 HAZ WASTE CA FAC STATE SERVICE PR506998 0606 TREVENA ACTIVE Y N A I D <br /> 2399 UNIFIED PROGRAM FAC STATE SERV PR506999 0606 TREVENA 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 <br /> ate / /Water System to be TRANSFERED: x $150.00 = Amount Paid Date-/—/— <br /> Payment <br /> ate_/ /Payment Type Check # Recvd by <br />