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Date run 2/11/2016 4:44:44PR SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br />Run by Pagel <br />Facility Information as of 2/11/2016 <br />Record Selection Criteria: Facility ID FA0019957 <br />OWNER FILE INFORMATION Number of facilities for this owner: 1 <br />Owner ID <br />OW0016380 <br />Owner Name <br />SIMSMETAL <br />Owner DBA <br />SIMS METAL MANAGEMENT <br />Owner Address <br />1000 S AURORA ST <br />Mailing <br />Mailing Address <br />STOCKTON, CA 95206 <br />Home Phone <br />Not Specified <br />Work/Business Phone <br />510-412-5300 <br />Mailing Address <br />1000 S AURORA ST <br />Bos District <br />STOCKTON, CA 95206 <br />Care of <br />15132022 <br />FACILITY FILE INF ATION <br />Facility / CERS ID FA0019957 10187465 <br />Facility Name <br />SIMS METAL MANAGEMENT \ <br />Location <br />820 S AURORA ST <br />STOCKTON, CA 95206 <br />I <br />Phone <br />209-948-4000 <br />Mailing <br />Mailing Address <br />1000 S AURORA ST l <br />STOCKTON, CA 95206 / <br />Care of <br />Location Code <br />01-STOCKTON / <br />Bos District <br />001 - VILLAPUDUA, CARDS` <br />APN <br />15132022 <br />EMERGENCY <br />INFORMATION <br />Contact Name <br />Title <br />Day Phone <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0035536 <br />Mail Invoices to Owner <br />Account Name SIMSMETAL <br />Account Balance as of 2/11/2016: <br />Make changes/corrections in RED ink. <br />INFORMATION CHANGE (date) - L <br />OWNERSHIP CHANGE (date) <br />SSN /Fed Tax ID <br />New Owner ID : <br />Alt Phone <br />Fax <br />EMail : <br />New Account ID: : <br />Mail Invoices to: Owner / Facility / Account <br />(Circle One) <br />(Circle One) <br />Transfer to Active/Inactve <br />Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br />1921 - HMBP-Regular-Primary Location PR0530801 EE0009817 - ROBERT LOPEZ Active Y N A O D <br />ERSC - ELECTRONIC REPORTING STATE SURCHARG PR0532901 Inactive Y N A I D <br />BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site, andror project specific, PHS/EHD hourly charges associated with this facility <br />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 Ordinance Codes and/or Standards and State and/or <br />Federal Laws. <br />APPLICANT'S SIGNATURE: <br />Date <br />Program Records to be TRANSFERED: ' $25.00 = Amount Paid Date <br />Water System to be TRANSFERED: Amount Paid Date <br />Payment Type Check Number Received by <br />EHD Staff: EI= "-_ 2-- Date _ Z P Account out: Date 3 / t5 / 1(0 <br />COMMENTS: <br />Invoice #: <br />� 6coa i p n OLA <br />1 on ") r b' Vcr.-Sc- cAv II S e. �w` <br />