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Date win 3/12/2015 3:48:32Pn SAN JOAQU[N COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Run by Report M21 <br /> Facility Information as of 3/12/2015 Pagel <br /> Record Selection Criteria: Facility ID FA0009186 <br /> Make changes/corrections in RED Ink. <br /> INFORMATION CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 2 OWNERSHIP CHANGE(date) <br /> SSN/Fed Tax ID <br /> Owner ID <br /> OW0007186 Case Number: H01813 New owner 1D <br /> Owner Name MCGILL DEVELOPMENT LLC <br /> Owner DBA MCGILL AIRFLOW LLC <br /> Owner Address 1 MISSION PK <br /> GROVEPORT, OH 43125 <br /> Home Phone 614-830-2320 <br /> Work/Business Phone 209-466-2351 <br /> Mailing Address 1 MISSION PK <br /> GROVEPORT, OH 43125 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0009186 10182493 <br /> Facility Name MCGILL AIR FLOW LLC <br /> Location 1747 E DR MARTIN LUTHER KING JR BL\o <br /> STOCKTON, CA 95205 <br /> Phone 209-466-2351 x <br /> Mailing Address 1747 E DR MARTIN LUTHER KING JR BLVD <br /> STOCKTON, CA 95205 <br /> Care of MCGILL AIRFLOW LLC <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 001 -VILLAPUDUA, CARLOS Fax <br /> APN 15512018 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016186 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: owner / Facility I Account <br /> Account Name MCGILLAR=&OW LLC (CiraeOne) <br /> Account Balance as of 3/12/2015: 713.00 e-0'1r Ue, -41 0'P *)I f LI 1 S <br /> (Circle Ona) <br /> Transferee Adive <br /> PrograMElement and Description ReID Employee ID and Name Status New Ownef/ Delete <br /> 1921 -HMBP-Regular-Primary Location PR0520857 EE0000006-HAZA SAEED Active Y N AD <br /> 2220-SM HW GEN<5 TONSNR PR0513690 EE0009488-JEFFREY WONG Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511474 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PR0509186 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0532218 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT'. I,the undersigned ownsi operator or agent of same,acknowledge that ell site,i ndor project specife,PHSEHD 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,Nat all operations will be performed in accordance with all applicable Ordinanoe Codes and,or Standards and State andor <br /> Federal Laws <br /> APPLICANTS SIGNATURE: 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 Re e b <br /> REHS: 0 ADL—. -2R �f� Date / / Account out: Date.. J / /S <br /> COMMENTS: <br />