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Date run 12110/2008 2:49:01P SAN JOA '!N COUNTY ENVIRGNMENTAL HEALT--DEPARTMENT Report#5021 <br /> Run by. 4006 Pagel <br /> Facility Information as of 12/10/20 <br /> Record Selection Criteria: Facility ID FA0006909 <br /> Make changesicorrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN 1 Fed Tax ID <br /> Owner ID OW0005672 New Owner ID <br /> Owner Name METRO ROOTER INC <br /> Owner DBA ET SERVICES <br /> Owner Address 10140 E MCKINLEY <br /> SANGER, CA 93657 <br /> Home Phone 559-456-1225 <br /> Work/Business Phone 559-456-1270 <br /> Mailing Address PO BOX 608 <br /> CLOVIS, CA 936130608 <br /> Care of JEFF & LAURA PETERS <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0006909 <br /> Facility Name ET SERVICES <br /> Location D0 410 tj t' fG <br /> FRESNO, CA 93727 <br /> Phone 559-456-1270 <br /> Mailing Address PO BOX 608 <br /> CLOVIS, CA 936130608 <br /> Care of JEFF & LAURA PETERS <br /> Location Code 98-OUT OF COUNTY Alt Phone <br /> BOS District Fax <br /> APN EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name JACK PETERS <br /> Title <br /> Day Phone 209-456-1270 <br /> Night Phone 209-456-1225 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0009752 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner 1 Facility I Account <br /> Account Name ET SERVICES (Circle One) <br /> Account Balance as of 12/10/2008: $150.00 <br /> (Circle One) <br /> Transfer to Aclivellnaclve <br /> ProgramlUement and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 4244-PUMPER TRUCK PRO505631 EE0009374-LARRY GODINHO Inactive Y N A I D <br /> 4244-PUMPER TRUCK PR0523600 EE0004045-TED TASIOPOULOS Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project spec,PHSlEHD 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 and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: lZ Date Ly / <br /> Program Records to be TRANSFERED: *$20.00= Amount Paid Date 1 <br /> Water System to be TRANSFERED: $372.00= Amount Paid Date t I <br /> Payment Type Check Number Received by p- <br /> REHS: Date / ! Account out: ate 1�f ! o <br /> COMMENTS: <br /> 11phs-ehsgl-ntlappslenvisionskreports15021.rpt <br />