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Date run 4/21/2017 8:18:40M SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Paget <br /> Facility Information as of 4/21/2017 <br /> Record Selection Criteria: Fadlity ID FA0005626 <br /> Make changes/corrections in RED Ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 2 SSN/Fed Tax ID <br /> Owner ID OW0004451 New Owner ID <br /> Owner Name Richard E. Sanborn <br /> Owner DBA SANBORN CHEVROLET INC <br /> OwnerAddress 1210 S CHEROKEE LN <br /> LODI, CA 95240 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-334-5000 <br /> Mailing Address P.O. Box 1057 <br /> Lodi, CA 95241-1057 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0005626 10181899 <br /> Facility Name SANBORN CHEVROLET INC <br /> Location 1210 S CHEROKEE LN <br /> LODI, CA 95241 <br /> Phone 209-334-5000 x <br /> Mailing Address P.O. Box 1057 <br /> Lodi, CA 95241-1057 <br /> Care of Sanborn Chevrolet <br /> Location Code 02- LODI Alt Phone <br /> BOS District 004-WINN, CHARLES Fax <br /> APN 04728013 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0006259 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name Sanborn Chevrolet, Inc. (Circle One) <br /> Account Balance as of 4/21/2017: $0.00 <br /> (Cirde One) <br /> Transfer to Activeflnac <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PRO519414 EE0008709-JAMIE LIMA Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO511429 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2228-GEN 25<50 TONS PERMIT PRO605935 EE9999998-ONE VACANTI Active Y N A I D <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0502946 EE9999998-ONE VACANTI Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FI PR0507602 EE9999998-ONE VACANTI Inactive Y N A I D <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0528318 EE9999998-ONE VACANTI Active Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO522805 EE0002622-BENJAMIN ESCOTTO Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGI PRO532289 Inactive Y N A I D <br /> Gh(AVA�e PE 2228 -+D PE 2229 . 6ased on L412-i ol Inspection. <br />