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Date run7/21/2010 3:24:16Pn SAN JOA COUNTY ENVIRONMENTAL HEALT�EPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as Of 7/21/2010 <br /> Record Selection Criteria: Facility ID FA0014239 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0001165 New Owner ID <br /> Owner Name CITY OF STOCKTON <br /> Owner DBA <br /> Owner Address 305 N EL DORADO ST STE 200 _ <br /> STOCKTON, CA 95202 <br /> Home Phone 209-465-4528 <br /> Work/Business Phone 209-946-9222 <br /> Mailing Address 22 E WEBER AVE#350 <br /> STOCKTON, CA 95202 <br /> Care of CITY OF STOCKTON <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0014239 <br /> Facility Name PARCEL 2A <br /> Location 666 WEBER AVE <br /> STOCKTON, CA 95670 <br /> Phone <br /> Mailing Address 305 N EL DORADO ST <br /> STOCKTON, CA 952021997 <br /> Care of REDEVELOPMENT AGENCY <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN 13737002 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name CITY OF STKN REDEVELOPMENT AGENCY <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0024156 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name SECOR INTERNATIONAL INC (Circle One) <br /> Account Balance as of 7/21/2010: $0.00 <br /> (Circle One) <br /> Program/Element and DescriptionRecord ID Employee ID and Name Status Transfer to Active/Inactve <br /> New Owner? Delete <br /> 2960-RWQCB SITE PRO519031 EE0000942-MARGARET LAGORIO 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 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 antl/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: '$372.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br /> \\eh-env\envision\reports\5021.rpt <br />