HomeMy WebLinkAboutBUSINESS PLAN 8/26/1994ACCOUNTS RECEIVABLE ADJUSTMENT
HM806201
A¢~=ount Number
September 26~ 1994
Date
Esther Duran
From
Fire Department - Hazardous Materials Division
Department/Division
R AND G SLOANE
New Aocount
New Address
Close A,~ount
Service Change
Other Adjustments X
Billing Name
7021 SCHIRRA CT
Billing Address
Site Address
Parcel # (If Applicable)
Landlord Name & Address (If Applicable)
ADJUSTMENT
Last Billed Correct Billing AdJuatment to Effective Date of
Billing Change
<20.15> 09.26-94
Apl~(=vecl/By: -~
Remarka: BUSINESS NO LONGER HANDLES HAZARDOUS MATERIALS. THEY PAID THEIR BILL
AND WE AGREED TO ADJUST THE REMAINING BALANCE.
Utilities General Account Maintenance 09/26/94 PUTLS801
Acct Nbr: 806201 Bill Stat: NO
Cyc Stat: CL Acct Cyc Stat: CL
Transfer-from:
Transfer-to:
Page 1 of 6
Due: 20.15
1. Customer Name: R AND G SLOANE
2. Social Sec Nbr:
4. Service Address: 7021 SCHIRRA CT
5. Service City: BAKERSFIELD
8. Parcel ID:
9. Bill Cycle: 5
10. Route Nbr: 1
11. Comments :
12. Prey Acct: 23.
13. Service Date:
14. Fund no:
15. Billto Ad1:7021SCHIRRA CT
16. Billto Ad2:
17. Bill-to City: BAKERSFIELD
6. State: CA
20. Water Svc Class:
3. Telephone: 805-837-4841
7. Zip: 93313
Misc Services: 23.1 F09 HAZ MAT HANDLING
23.2
23.3
23.4
24.~Closing Date:
18. State: CA 19. Zip: 93313
Enter Save(S), Cancel(XX), Next Page(/), or Field # to Change
BAKERSFIELD CITY FIRE DEPARTMENT
HAZARDOUS MATERIALS DIVISION
1715 -CHESTER .A¥_E'.
. BAKERSFIELD, CA. 93301
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
To avoid further action, return this form within 30 days of receipt.
TYPEIP~INT ANSWERS IN ENGLISH.
Answer'the questions below for the business as a whole.
Be brief and concise as po~ibte.
SECTIOhl 1'BUSINESS' NAME' BUSl N ESS IDEN~F4~CATIO N DATA -.
MAILING ADDRESS:
CITY: STATE: ~ ZIP: PHONE:
DUN & BRADSTREET NUMBER:
SIC CODE:
PRIMARY ACTIVITY:
OWNER;
MAILING ADDRESS'
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT
TITLE BUS. PHONE 24 HR. PHONE
.1.
.. Bakersfield FL~e Dept.
:ardous 1V~aterials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING:
NUMBER OF EMPLOYEES:
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
SECT[ON 4: EXEMPTION REQUEST:
I CERTIFY UNDER PENALTY OF PERJURY THAT-MY BUSINESS IS EXEMPT FROM THE
REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH &
SAFETY CODE" FOR THE FOLLOWING REASONS:
.,.--WE OD NOT HANDLE HAZARDOUS MATERIALS.
WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO
TiMEEXCEED THE MINIMUM REPORTING QUANTFTIES.
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION:
MATiON IS ACCURATE. I UNDERST~SINFORMATION WILL BE USED TO
FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE"
ON HAT/RDOUS MATERIALS (DIV.. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND TH~,T "
· INACC/.JRATE INFORMATiON.CONSTiTUTES PERJURY. _
SIGNATU, I~ TITLE ~' DATE·
2.
R&G
SLOANE
Team Leader
7021 Schirra Court
Bakersfield, CA. 93313
(805) 837-2295
Fax: (805) 837-4841
Utilities General Account Maintenance PUTLS801
Acct Nbr: 782301 Bill Stat: NO
Cyc Stat: CL Acct Cyc Stat: CL
1. Customer Name: R AND G SLOANE
2. Social Sec Nbr:
4. Service Address: 7021SCHIRRA CT
5. Service City: BAKERSFIELD
8. Parcel ID:
9. Bill Cycle: 1
10. Route Nbr: 45
11. Comments : T-F
12. Prev Acct: 23.
13. Service Date: 04/01/93
14. Fund no:
15. Billto Ad1:7021 SCHIRRA CT
16. Billto Ad2:
17. Bill-to City: BAKERSFIELD
Transfer-from: Page 1 of 6
Transfer-to: Due: 0.00
3. Telephone: 805-837-2295
6. State: CA 7. Zip: 93313
20. Water Svc Class:
Misc Services: 23.1 122 1 ,2 YD 2 DAYS/WK
23.2 CGF COUNTY GATE FEE
23.3
23.4
24. Closing Date:
18. State: CA 19. Zip: 93313
Enter Save(S), Cancel(XX), Next Page(/), or Field # to Change
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