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Date run 10/20/2015 4:27:59P SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report #5021 Run by Pagel Facility Information as of 10/20/2015 Record Selection Criteria: Facility ID FA0009086 Make changes/corrections in RED ink. INFORMATION CHANGE (date) OWNERSHIP CHANGE (date) OWNER FILE INFORMATION Number of facilities for this owner: 1 Owner ID OW0007086 Case Number: H01037 Owner Name EMERSON ELECTRIC Owner DBA ASCO POWER TECHNOLOGIES LP Owner Address 705 N CARLTON AVE Owner / STOCKTON, CA 95203 Home Phone Not Specified Work/Business Phone 209-941-4111 Mailing Address PO BOX 1995 Care of STOCKTON, CA 95201 Care of 01-STOCKTON FACILITY FILE INFORMATION Facility ID / CERS ID FA0009086 10182401 Facility Name ASCO POWER TECHNOLOGIES LP Location 705 N CARLTON AVE Owner / STOCKTON, CA 95203 Phone 209-941-4111 x Mailing Address PO BOX 1995 STOCKTON, CA 95201 Care of ASCO Power Tech nologires,LP Location Code 01-STOCKTON Bos District 001 - VILLAPUDUA, CARLOS APN 13321003 EMERGENCY NOTIFICATION CONTACT INFORMATION Contact Name Title Day Phone Night Phone ACCOUNTS RECEIVABLE FILE INFORMATION SSN / Fed Tax ID New Owner ID : Alt Phone Fax EMail : Account ID AR0016086 New Account ID: : Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account Account Name ASCO POWER TECHNOLOGIES LP (Circle One) Account Balance as of 10/20/2015: $0.00 (Circle One) Transfer to Active/Inactve Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete 1921 - HMBP-Reqular-Primary Location PRO519372 EE0009817 - ROBERT LOPEZ Active Y N AD 2220 - SM HW GEN <5 TONS/YR PR0513631 EE0001421 -STACY RIVERA Active Y N A I D 2224 - HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511374 EE0000000 - HAZ MAT SJC OES Inactive Y N A D 2399 - UNIFIED PROGRAM FAC STATE SURCHARGE F PRO509086 EE0000000 - HAZ MAT SJC OES Inactive Y N A I D 2840 - AST EXEMPT FAC < 1,320 GAL PR0531189 EE0001421 - STACY RIVERA Inactive Y N A I D ERSC - ELECTRONIC REPORTING STATE SURCHARG PR0532303 Inactive Y N A I D 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 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 Codes and/or Standards and State and/or Federal Laws. ,Ordinance (/y6 (�f !/v� �6 APPLICANT'S SIGNATURE: Date / ! Program Records to be TRANSFERED: ` $25.00 = Amount Paid Date Water System to be TRANSFERED: Amount Paid Date Payment Type C c Number Received b EHD Staff: to 1Q_/ Account out:_ Date _LO/ COMMENTS: Invoice #: