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Date run 8/1212014 11.11:10AI SAN JC UIN COUNTY ENVIRONMENTAL 1fEA. I DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 8/12/2014 <br /> Record Selection Criteria. Facility ID FACO22489 <br /> Make changesicorrections in RED ink. <br /> INFORMATION CHANGE(date) _ <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 1 SSN 1 Fed Tax ID <br /> Owner ID OVV0019990 New Owner ID <br /> Owner Name METROPCS CA, LLC <br /> Owner DBA <br /> Owner Address <br /> Home Phone Not Specified <br /> Work/Business Phone 888-313-0188 <br /> Mailing Address 785 ORCHARD DRIVE SUITE 200 <br /> FOLSOM, CA 95630 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID 1 CERS ID FA0022489 10406662 <br /> Facility Name Metri CA, LLC SAC011 <br /> Location 3485 Brookside Ind <br /> Stockton, CA 95219 <br /> Phone 888-313-0188 x <br /> Mailing Address 785 ORCHARD DRIVE SUITE 200 <br /> FOLSOM, CA 95630 <br /> Care of METROPCS CA, LLC <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN El <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0041159 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility I Account <br /> Account Name MetroPCS CA, LLC SAC011 (Circle One) <br /> Account Balance as of 8112/2014: $0.00 <br /> (Circle One) <br /> Transferto Activellnactve <br /> ProgramlElement and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1926-HMBP-Unstaffed Network Location PR0539337 EE0000006-HAZA SAEED 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,PHSiEHD 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 ancilor Standards and State andfor <br /> Federal Laws <br /> AP'PLICANT'S SIGNATURE. Date 1 1 <br /> Program Records to be TRANSFERED: '$25,00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date 1 1 <br /> Payment Type Check Number Recie <br /> REHS: Date 1 1'L! L` Account out: Date lJJf <br /> COMMENTS. <br /> K_N,J F P l L ID C-0 V+ ILLS . <br /> E f P T �'72stm. I N—4 t J1J&, <br />