Laserfiche WebLink
L <br /> Run by NORA San Joaquin County PHS/EHD <br /> FACILITY INFORMATION as of 12/24/97 Report ##5021 <br /> OWNER FILE INFORMATION Make changes/corrections in RED pen or pencil: <br /> INFORMATION CHANGE (date): <br /> OWNERSHIP CHANGE (date): <br /> OWNER ID: 000084 New owner ID: 00 <br /> Owner Name: A W RY <br /> Owner DBA: <br /> Owner Address: 'Per-13C=55 <br /> Home Phone: 209-368-5151 <br /> Soc Sec# / Tax ID#: <br /> ownership Type: 01 CORPORATION <br /> Mailing Address: PO--BQX__ , <br /> Care of: <br /> WOODBRIDGE, CA 95258 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 000100 <br /> Facility Name.--GA ABA "� r,,�—.T � <br /> Location: 18180 N GUILD AVE <br /> 170DI 95240 <br /> Phone: 209-368-5151 <br /> Mailing Address: <br /> Care of: C <br /> WOODBRIDGE, CA 95258 <br /> Location Code: 99 APN: <br /> BOS District: 004 SIC Cade: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT ID: 0000100 New Account ID: 000 <br /> Mail Invoices to: Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name: CANADAIGUA WINERY (Circle one) <br /> Account Balance as of 12/24/97: $0 . 00 <br /> (Circle one) <br /> Record UST(s) Transfer to Activate / Inactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <br /> 1617 RETAIL MARKET > 1000 SQ FT PER PR163220 0843 COLLINS INACTIVE Y N A I D <br /> 2950 ENVIRON ASSESS PR500399 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: NR Date UNIT/FiLe:—/—/ <br /> %.11 <br />