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Repor <br /> Date run 10/212006 3:02:04PA -TIN COUNTY ENVIRONMENTAL HEAL." (DEPARTMENT Pagel lf5o21 <br /> SAN JOE <br /> Run by Romp, Pagel <br /> Facility Information as of 10/2/200 <br /> Record Selection Criteria: f=acility ID FA0016482 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0008071 Case Number: H06440 New Owner ID <br /> Owner Name RIPON FARM SERVICES <br /> Owner DBA RIPON FARM SERVICE <br /> Owner Address 938 S HWY 99 E FRONTAGE RD <br /> RIPON, CA 953660806 <br /> Home Phone 209-476-8213 <br /> Work/Business Phone 209-599-2188 <br /> Mailing Address PO BOX 806 <br /> RIPON, CA 953660806 <br /> Care of OUDEN, BUD DEN <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016482 <br /> Facility Name RIPON FARM SERVICE <br /> Location 932 S HWY 99 E FR RD <br /> RIPON, CA 95366 <br /> Phone 209-599-2188 <br /> Mailing Address 938 FRONTAGE RD <br /> RIPON, CA 95366 <br /> Care of <br /> Location Code APN:26102007/11 <br /> BOS District 005-ORNELLAS, LEROY SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0029006 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name ISOLA AND ASSOCIATES LLP (Circle One) <br /> Account Balance as of 101212006: $0.00 <br /> Y (Circle One) <br /> 4Transfer to Activellnactve <br /> ProgramlElement and Description Record ID Employee ID and Name Status New Owner? Delete <br /> -WA-TER-QUALLfY_SlT-EPROJECT— PR0524571 EE0001459-VICKI MCCARTNEY 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 hourty charges associated with this <br /> facility or activity will be billed to the party identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinate Codes andlor Standards and <br /> State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date 1 1 <br /> Program Records to be TRANSFERED: `$20.00= Amount Paid Q&Q5 Date <br /> Water System to be TRANSFERED: `$372.00= Amount Paid Date 1 I <br /> Payment Type C eck Number � — Rece'v by <br /> REHS: Date I67�1AA Account out: Date <br /> COMMENTS: <br /> llphs-ehsgl-ntla ppslenvisionslreports15021.rpt <br />