My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
W
>
WEST
>
2303
>
2900 - Site Mitigation Program
>
PR0523970
>
SITE INFORMATION AND CORRESPONDENCE
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
7/7/2020 8:49:42 AM
Creation date
7/7/2020 8:45:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0523970
PE
2950
FACILITY_ID
FA0016125
FACILITY_NAME
R & L DIESEL
STREET_NUMBER
2303
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95205
APN
11709027
CURRENT_STATUS
01
SITE_LOCATION
2303 WEST LN
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
23
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
D,1' 4006 <br /> :;/26/2009 4:25:08PN SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run y <br /> Facility Information as of 5/26/2009 Pagel <br /> Record Selection Criteria: Facility ID FA0016125 <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 OW0013025 New Owner ID <br /> Owner Name THOMAS, RANDALL F 1 r) <br /> Owner DBA @�,� 9YtB��.ip..S <br /> Owner Address 21710 N MAY RD <br /> ACAMPO, CA 95220 <br /> Home Phone 209-955-2022 <br /> Work/Business Phone Not Specified <br /> Mailing AddressND-C-ANAL-BtVf) STE`"�6 <br /> SIO-CISTON, CA 95207, in C ,� rn A0 `rJr�;—A <br /> Care of <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility ID FA0016125 R F iese <br /> Facility Name <br /> Location 2303 WEST LN <br /> STOCKTON, CA 95205 <br /> Phone <br /> Mailing Address - S <br /> ernrv-rnnl re oG�m <br /> Care of <br /> Location Code 99- UNINCORPORATED P Alt Phone <br /> BOS District 002- RUHSTALLER, LARRY Fax <br /> APN 11709027 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name THOMAS, RANDALL <br /> Title <br /> Day Phone 209-955-2027 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID ,AR00281� C ..O. New Accou <br /> I,�`,ItJI ^A�10 <br /> Mail Invoices to -Account �— I Mail Invoices to: Owner Facility / Account <br /> Account Name 6L:6JON GRO1IP SERVICES ,r�1 -__„ ,,, �r (Circle One) <br /> Account Balance as of 5/26/2009: $-46.50 <br /> I" (Circle One) <br /> Y Transfer to Active/Inaclve <br /> Program/Element and Description Record ID Employee ID and Name Status New Omen Delete <br /> 2950-ENVIRON ASSESS PR0523970 -I •5 Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operatdrRor agent of aama�acknoy{eage mar t all she,andior project specific,PHS/EHD hourly charges associated with this <br /> facility or activity Wil 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 andror Federal Laws. �� 1, 1� <br /> APPLICANT'S SIGNATURE: "`"" A-r7'+CSC� Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: "$372.00= Amount Paid 37 Datel'f. l_L <br /> Payment Type LI/ Check Number Received by_'� _ <br /> REHS: `� 1\ Date Accountout: �� Date _/_;Llf/ 0 7 <br /> COMMENTS: <br /> \\eh-env\envis ion\reports\5021.rpt • <br />
The URL can be used to link to this page
Your browser does not support the video tag.