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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0506509
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
6/1/2020 12:26:14 PM
Creation date
6/1/2020 12:12:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0506509
PE
2960
FACILITY_ID
FA0007466
FACILITY_NAME
GEORGIA PACIFIC CORP (FORMER)
STREET_NUMBER
75
Direction
W
STREET_NAME
VALPICO
STREET_TYPE
RD
City
TRACY
Zip
95336
APN
24613007
CURRENT_STATUS
01
SITE_LOCATION
75 W VALPICO RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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Date run 11/15/01 9:15:07AM SANUIN COUNTY PUBLIC HEALTH SER*S Report x: 6023 <br /> Runby Facility Information as of 11/15/01 Page u: 1 <br /> Record Selection Criteria: Facility ID FA0007466 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID: OW0006172 New Owner ID <br /> Owner Name: S W REALITY COMP INC <br /> Owner DBA: <br /> Owner Address: 6892 MARLIN CIR <br /> LA PALMA, CA 90623 <br /> Home Phone: 209-836-2151 <br /> Work/Business Phone: 714-521-9340 <br /> Mailing Address: PO BOX 5399 <br /> BUENA PARK, CA 90622 <br /> Care of: HUGHES, GEORGE <br /> FACILITY FILE INFORMATION <br /> Facility ID: FA0007466 <br /> Facility Name: GEORGIA PACIFIC CORP (FORMER) <br /> Location: 75 W VALPICO RD <br /> TRACY, CA 95336 <br /> Phone: <br /> Mailing Address: 75 W VALPICO RD <br /> TRACY, CA 95336 <br /> Care of: S W REALITY COMP INC <br /> Location Code: 03-TRACY APN: <br /> BOS District: 005- BEDFORD, LYNN SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID: AR0011540 New Account ID: <br /> Mail Invoices to: Account Mail Invoices to: Owner/Facility/Account <br /> Account Name: ACTON MICKELSON ENVIRONMENTAL (Circle One) <br /> Account Balance as of 11/15/01: $-267.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2960-RWQCB CLEAN UP SITE PR0506509 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,and/or project speck,PHS/EHD hourly 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 Ordinace 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 TRANSFERED: —*$150.00= Amount Paid Date—I—/— <br /> Payment <br /> /Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br /> \\Phs-ehsql-nt\apps\Envisions\Reports\5021.rpt <br />
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