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4B 01b r:tSVWe I [ 1� E��l� ' )f= 09/12/94 <br /> ke changes/corrections in RED pen or pencil: <br /> OWNER FILE INFORMATION Date of INFORMRTION CHANGE: <br /> Date of OWNERSHIP CHANGE: <br /> OWNER ID: 000084 New Owner ID: 00 <br /> Owner Nage: CANADA I GUA WINERY <br /> Owner DBA: CANADAI GUA WINERY <br /> Owner Address: FSO BOX 55 <br /> WOODBRIDGE, CA 95258 <br /> Home Phone: 209-368-5151 <br /> Work/Business Phone: <br /> Nailing Address: RSO PDX 55 <br /> Care of: DEWOLF, V/CANADAIGUA WINERY <br /> WOODBRIDGE, CA 95256 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 000100 <br /> Facility Name: CANADAI GUA WINERY <br /> Location: 18180 N GUILD AVE <br /> LODI 95240 <br /> Phone: 209-368-5151 <br /> Mailinqq Address? P O PDX 55 <br /> y Care of: CANADAI GUA WINERY <br /> WOODBRIDGE, CA 95258 <br /> Location Code: 02 APN: <br /> 205 District: 02 SIG Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> AMOUNT ID: 0000100 New Account ID: 000 <br /> Nail Invoices to: eac i I i t YD Mail Invoices to: Owner t(F`ac <br /> Account Name: CANADAI GUA WINERY <br /> Account Balance as of 09/12/94 : $ 0. 00 <br /> FILES LINKED: No WATER SYSTEM FILE linked <br /> Record UST(s) Transfer to Activate ! Inactivate <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> ------------------------------------------------------------------------------- <br /> 1617 RETAIL MARKET ) ION SO FT PR163220 0740 ASKANAS INACTIVE N A I D <br /> 2950 ENVIRON ASSESS <br /> PR5039 <br /> 09 0694 MACTIV N A I D <br /> ------------------------- -------------------- <br /> BIL.INB and COWLIM ACKNOWLEDGEMENT: 1, the undersigned owner, operator or agent of same, acknowledge that all site and/or <br /> project specific PMS/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 / /9 <br /> ----------_................._.....__....................____._......................__........._..,..---------------__....—.................._________..._____..........__ <br /> Programs to be TRAN5FERED: x 120.00 - Amount Paid Date /_/9— <br /> Payment <br /> /9Payment Type Check # Recvd by <br /> ------------------------------------------------------------------------------- <br /> RENS or COUNTER SUPV: Date /_/9— ACCT out: Date—/—/9— UNIT/File: / /9— <br />