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Date run : 3/26/01 11:51:48AM �AQUIN COUNTY PUBLIC HEALTH SE ES Report #: 0002 <br /> Run by 13WOODWARD Facility Information as of 3/26/01 Page #: 2 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE (date) <br /> OWNER FILE INFORMATION <br /> Owner ID: OW0009429 New Owner ID <br /> Owner Name; CITY OF STOCKTON <br /> owner DBA; HOUSING & REDEVELOPMENT DEPT <br /> owner Address305 N EL DORADO ST <br /> CSTOCKTON, CA 95202-199 <br /> Home Phone: 209-937-8840 <br /> Work/Bussness Phone: Not Specified <br /> Mailing Address: 305 N EL DORADO ST <br /> STOCKTON, CA 95202-1997 <br /> Care of: HOUSING & REDEVELOPMENT DEPT <br /> FACILITY FILE INFORMATION <br /> Facility ID: FA0012153 <br /> Facility Name: SOUTH SHORE PARCEL <br /> Location: WEBER AVE <br /> STOCKTON, CA 95202 <br /> Phone: <br /> Mailing Address: 305 N EL DORADO ST <br /> STOCKTON, CA 95202-1997 <br /> Care of <br /> Location Code: APN: <br /> BOS District; SIC Code; <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID; AR0019491 New Account ID:: <br /> o l Mail Invoices to: Account Mail Invoices to; Owner/ Facility/Account <br /> 1 ! Account Name; STOCKTON REDEVELOPMENT AGENCY (Circle One) <br /> 31 Account Balance as f 3/26/01: $0.00 <br /> 5� (Circle One)t <br /> a- UST(s) Transfer o Active/Inactve <br /> Program Element and Description Record ID Employee ID and Name Status Linked New Owner? Delete <br /> 2950- NVIRON ASSESS PRO515450 EE0009488-WONG Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge thatall site,and/or <br /> project specific,PHS/EHD hourly charges associated with this facility or activity wgl be billed to the party identified as the BILLING PARTY on this <br /> form. I also certify thatall operations will be performed in accordance with all applicable Ordinace Codes and/or Standards and State and/or Federal <br /> Laws. <br /> APPLICANT'S SIGNATURE: Date I I <br /> Program Records to be TRANSFERED: "$0.00= Amount Paid Date / / <br /> Water System to be TRANSFERED: '$150.00= Amount Paid Date / / <br /> Payment Type Check Number Receipt Number Receiv dy D <br /> REHS: Date / / Account out: Date .h <br /> UUMMLIN 15: <br /> 1.0.0.89.00 <br />