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Date run : 3/26/01 11:51:48AM SAWAQUIN COUNTY PUBLIC HEALTH SE ES Report #: 0002 <br /> Run by BWOODWARD 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 Address; 305 N EL DORADO ST <br /> STOCKTON, CA 95202-1997 <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 to:: <br /> ��IDI Maillnvoicesto: Account Mail Invoices to: Owner/ Facility/Account <br /> Account Name: STOCKTON REDEVELOPMENT AGENCY (Circle One) <br /> j Account Balance a��3/26/01: $0.00 <br /> �q (Circle One) <br /> 1 UST(s) Transfer to Activeelete e <br /> Pr6A11ogram Element and Description Record ID Employee ID and Name Status Linked New Owner? Delete <br /> 2950- NVIRON ASSESS I PRO515450 EE0009488-WONG Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge that all site,and/or <br /> project specific,PHS/EHD hourly charges associated with this facility or activity will be billed to the party identified as the BILLING PARTY on this <br /> form. I also certify that all operations will be performed in accordance with all applicable Ord inace Codes and/or Standards and State and/or Federal <br /> Laws. <br /> APPLICANT'S SIGNATURE: Date 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 Received by <br /> RENS: Date_/ I Account out: Date <br /> 1.0.0.89.00 <br />