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r <br /> All <br /> Date run 7/11/2008 8:42:38AN SAN JOAI COUNTY ENVIRONMENTAL HEAL _ EPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 7/11/2008 <br /> Record Selection Criteria: Facility ID FA0019016 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0004814 New Owner ID <br /> Owner Name PACIFIC GAS & ELECTRIC COMPANY <br /> Owner DBA <br /> Owner Address 77 BEALE ST <br /> SAN FRANCISCO, CA 94106 I it <br /> Home Phone 209-942-1566 <br /> Work/Business Phone 925-974-4231 <br /> Mailing Address 375 N WIGET LN SUITE 200 <br /> WALNUT CREEK, CA 94598 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019016 <br /> Facility Name PG&E TRACY SERVICE CENTER <br /> Location 502 E GRANT LINE RD <br /> TRACY, CA 95376 <br /> Phone 209-942-1570 <br /> Mailing Address 77 BEALE ST, MAIL CODE B24A <br /> SAN FRANCISCO, CA 94105 <br /> Care of <br /> Location Code 03-TRACY Alt Phone <br /> BOS District 005 -ORNELLAS, LEROY Fax <br /> APN 25027008 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone 209-942-1570 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> AccountlD AR0033838 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner I Facility I Account <br /> Account Name PARSONS (Circle One) <br /> Account Balance as of 7/11/2008: $-294.00 <br /> �•� VVV/ (Circe One) <br /> Transfer to Activellnactve <br /> Program/Element and Desyription Record ID / Employee ID and Name / Status / New Owner? Delete <br /> ✓ <br /> -ENVI ASSESS PR0528085 EE0000684-MICHAEL INFURNA Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andlor project specific,PHS/EHD hourly charges associated with this <br /> facility or activity will be billed to the party identified as the OWNER on this farm. I also certify that all operations will be performed in accordance with all applicable Ordinate Codes and/or Standards and <br /> State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: `$20.00= Amount Paid Date <br /> Water System to be?T SF ED: `$372.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Cs— Date <br /> COMMENTS: <br />