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te run 10/11/2006 10:48:511 SAN JO N COUNTY ENVIRONMENTAL HEALOEPARTMENT Report#5021 <br /> -Runby Pagel <br /> Facility Information as of 10/11/2006 <br /> Record Selection Cntena: Facility ID FA0012793 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0009967 New Owner ID <br /> Owner Name STUDLEY COMPANY <br /> Owner DBA MUSCO OLIVE PRODUCTS INC <br /> Owner Address 17950 W VIA NICOLO <br /> TRACY, CA 95377 <br /> Home Phone 209-836-4600 <br /> Work/Business Phone Not Specified <br /> Mailing Address 17950 W VIA NICOLO <br /> TRACY, CA 95377 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0012793 <br /> Facility Name MUSCO OLIVE PRODUCTS INC <br /> Location 17950 W VIA NICOLO <br /> TRACY, CA 95377 <br /> Phone 209-836-4600 <br /> L <br /> Mailing Address 17950 W VIA NICOLO <br /> TRACY, CA 95377 <br /> Care of BEN HALL ( Su L✓_ 1a_ AA-eo <br /> Location Code 99- UNINCORPORATED AREA APN:20911032 <br /> BOS District 005-ORNELLAS, LEROY SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0021419 �y /",' I,G.?v` New Account ID: <br /> Mail Invoices to Account /"�- 0_/y' Mail Invoices to: Owner / Facility / Account <br /> AC a (Circle One) <br /> Account Balance as of 10/11/2006: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description ✓ Record 10 / Employee ID and Name ✓ Status ✓ New Omer? Delete <br /> 2965-WATER QUALITY SITE PROJECT PR0516772 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,ancuor project specificPH HD hourly charges associated min this <br /> facility or activity will be billed to Ne party identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applica a Ordinace Codes and/or Standards and <br /> Slate and/or Federal Laws. <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date / / <br /> Water System to be TRANSFERED: '$372.00= Amount Paid $�S—Date /0 / 3 / D.b <br /> Payment Type ✓ Check Number yfz$-6 O Received by 7*4— <br /> REHS: Date / / Account out: _ZoX- Date /O /_12-1 0 �o <br /> COMMENTS: <br /> 15, <br /> \\phs-e hsq I-n t\apps\e nvs ions\re ports\5021.rpt <br />