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i <br /> Date run 5/24/2004 9:17:56Ah SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report%5021 f <br /> Run by ► Pagel <br /> Facility Information as of 5/24/2004 <br /> F <br /> Record Selection Criteria: Facility ID FA0015067 IE <br /> E <br /> Make!changeslcorrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0012050 New Owner ID <br /> Owner Name TOGNINALI,ALDO & ROSALIE s <br /> Owner DBA s <br /> r <br /> Owner Address 14500 E HWY 4 I <br /> STOCKTON, CA 95215 € <br /> Home Phone 209-948-0494 i <br /> Work/Business Phone Not Specified € <br /> Mailing Address 14500 E HWY 4 .9 <br /> STOCKTON, CA 95215 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015067 <br /> Facility Name TOGNINALI, ALDO& ROSALIE <br /> Location 15420 E HWY 4 <br /> STOCKTON, CA 95215 <br /> I <br /> Phone 209-948-0494 I <br /> Mailing Address 14500 E HWY 4 <br /> STOCKTON, CA 95215 I <br /> Care of TOGNINALI, ALDO & ROSALIE <br /> Location Code 01 - STOCKTON APN: <br /> BOS District SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0025804EI New Account ID: <br /> .I <br /> Mail Invoices to Facility Mail Invoices to: Owner ! Facility / Account <br /> Account Name TOG AL , DO & ROSALIE (Circle One) <br /> Account Balance as of 5124120 4: $0.00 <br /> t (Circle One) <br /> � Transferto Activellnacive p <br /> ProgramfElement and Description Record ID Emp$oyee ID and Name ;I Sidtus New Owner? a !� <br /> 3030-UI CONTROL PROG SITE PRO522107 EE0000942-MARGARET LAGORIOAproje <br /> Y N I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,ant specific,PHS/EHD hourly charges soci 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 Ordinate Codes andlo andards and <br /> State and/or Federal Laws. .i <br /> r <br /> APPLICANT'S SIGNATURE: Date / ! <br /> .j <br /> Program Records to be TRANSFERED: *$20.00= Amount Paid ! Date ! 1 <br /> Water System to T SFERED: $155.00= Amount Paid :i Date 1 I <br /> Payment Type Check Number -Recei <br /> REHS: Date 1 Account out: i3 Date ll fJT <br /> COMMENTS: <br /> 'E <br /> IIPhs-ehsgl-ntlappslEnvisionslReports15021.rpt <br /> 'C) <br /> i� <br />