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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0504944
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
1/17/2020 10:50:53 AM
Creation date
1/17/2020 9:06:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0504944
PE
2950
FACILITY_ID
FA0006428
FACILITY_NAME
BRIDGES SPECIALTY CENTER, THE
STREET_NUMBER
2233
STREET_NAME
GRAND CANAL
STREET_TYPE
BLVD
City
STOCKTON
Zip
95219
APN
11011006
CURRENT_STATUS
02
SITE_LOCATION
2233 GRAND CANAL BLVD
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\sballwahn
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EHD - Public
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Run by : NORA San Joaquin County PHS/EHD Report #5021 <br /> FACILITY INFORMATION as of 02/06/96 <br /> - - - - <br /> OWNER FILE INFORMATION Make changes/corrections in RED pen or pencil: <br /> INFORMATION CHANGE (date): <br /> OWNERSHIP CHANGE (date): <br /> OWNER ID: 005145 New Owner ID: 00 <br /> owner Name: CHERN, PO YING <br /> Owner DBA: <br /> owner Address: 2233 GRAND CANAL BLVD <br /> STOCKTON, CA 95219 <br /> Home Phone: 209-474-1911 <br /> Work/Business Phone: <br /> Mailing Address: 17875 VON KARMAN <br /> care of: BRAZOS ASSET MGM INC <br /> IRVINE, CA 92714 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 006734 <br /> Facility Name: BRIDGES SPECIALTY CENTER, THE <br /> Location: 2233 GRAND CANAL BLVD <br /> STOCKTON 95219 <br /> Phone: 714-440-7700 <br /> Mai ling Address: 17875 VON KARMAN <br /> Care of: CRC ENVIRONMENT RISK MGM <br /> IRVINE, CA 92714 <br /> Location Code: 0 1 APN: <br /> BOS District: 002 SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION TO, 0 1q Z 0 <br /> ACCOUNT ID: 0940ORM New Account ID: 000 <br /> mail Invoices to: Account 1<011 �C d f f4z , Mai l Invoices to: Owner / Facility / Account <br /> Account Name: (Circle one) <br /> Account Balance as of 02/06/96 : $1, 170 . 00 (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 PR505361 0451 SASSON ACTIVE Y N A I D <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1, 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 /> J!. Payment/Type Check # Recvd by <br /> REHS or COUNTER SUPV: Date Z /!p / ACCT out Date z/ / UNIT/Fite:/ / <br />
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