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Date run 5/29/2009 1:07:32PN SAN JO ' )UIN COUNTY ENVIRONMENTAL HEE H DEPARTMENT Report#5021 <br /> Run by 4006 Pagel <br /> Facility Information as of 5/29/2009 <br /> Record Selection Criteria: Facility ID FA0012230 <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 OW0002957 New Owner ID <br /> Owner Name PG&E &CO <br /> Owner DBA PG& ev+/►�.U�/ <br /> Owner Address 375 N W I�CRELNSTE 200 <br /> WALNUT 94598 3g01 AhAl) AA P,4- RM. /'7 <br /> Home Phone 209-944-1450 <br /> Work/Business Phone Not Specified 50" P4/►wD� L'A �I yS83 <br /> Mailing Address 375 N W IGET LN STE 200 <br /> WALNUT CREEK, CA 94598 (Q'>- 4//i- G3??I <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0012230 <br /> Facility Name MCDONALD ISLAND GAS STORAGE FAC <br /> Location MCDONALD ISLAND <br /> HOLT, CA 95234 <br /> Phone <br /> Mailing Address 375 N W IGET LN STE 200 <br /> WALNUT CREEK, CA 94598 <br /> Care of ANN CONNER <br /> Location Code 99- UNINCORPORATED P Alt Phone <br /> BOS District 003 - BESTOLARIDES Fax <br /> APN EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name MR MEL WONG <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0019749 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name PG&E &CO (Circle One) <br /> Account Balance as of 5/29/2009: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2960-RWQCB SITE PR0515580 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,and/or 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 and/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 />