My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
BILLING
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
D
>
DR MARTIN LUTHER KING JR
>
508
>
1900 - Hazardous Materials Program
>
PR0521197
>
BILLING
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/1/2018 4:35:04 PM
Creation date
6/9/2018 1:46:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
BILLING
RECORD_ID
PR0521197
PE
1921
FACILITY_ID
FA0003720
FACILITY_NAME
CHARTER WAY PETRO INC.
STREET_NUMBER
508
Direction
W
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
16504016
CURRENT_STATUS
01
SITE_LOCATION
508 W DR MARTIN LUTHER KING JR BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
EJimenez
Supplemental fields
FilePath
\MIGRATIONS\D\DR MARTIN LUTHER KING JR\508\PR0521197\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
1/20/2016 9:34:01 PM
QuestysRecordID
2991082
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
4
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Date run ✓3/29/2016 11:22:09AI SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Run by <br />Facility Information as of 3/29/2016 <br />Report 95021 <br />Pagel <br />Record Selection Criteria: Facility ID <br />FA0003720 <br />2220 - SM HW GEN <5 TONSNR <br />PR0518549 <br />EE0001421 - STACY RIVERA <br />Active <br />Make changes/corrections in RED ink. <br />'0 Z" <br />"1 <br />EE0000000 - HAZ MAT SJC OES <br />Inactive <br />INFORMATION CHANGE (date) <br />1 <br />EE0000451 - STEVE SASSON <br />Inactive <br />OWNERSHIP CHANGE (date) <br />PR0231057 <br />OWNER FILE INFORMATION <br />Number of facilities for this owner: 5 <br />SSN/Fed Tax ID :_ <br />PR0507420 <br />Owner ID <br />OW0006297 <br />New Owner ID <br />PRO534556 <br />Owner Name <br />SAINI, SURINDER SINGH <br />Owner DBA <br />G'f�i9c'iF.0 .ty CiyFy='rte./ <br />Owner Address <br />14836 HARBOR CT <br />LATHROP, CA 95303 <br />Home Phone <br />209-992-1735 <br />Work/Business Phone <br />209-9.92-1735 <br />10 7 - �iGS'-3y iia <br />Mailing Address <br />14823 HARBOR CT <br />LATHROP, CA 95303 <br />Li9i/�e�i� Cts 9S' 33a <br />Care of <br />RAVINDER SINGH <br />FACILITY FILE INFORMATION <br />Site Mitigation Facility <br />Facility ID / CERS ID <br />FA0003720 10181345 <br />Facility Name <br />CHEVRON #92033* <br />Location <br />508 W DR MARTIN LUTHER KING JR BLV <br />Stockton, CA 95206 <br />Phone <br />209-465-3440 x <br />Mailing Address <br />508 W CHARTER WAY <br />STOCKTON, CA 95206 <br />Care of <br />SURINDER SINGH SAINI <br />Location Code <br />01 - STOCKTON <br />Alt Phone Zd g- 99,2 - /;73,5" <br />BOS District <br />001 - VILLAPUDUA, CARLOS <br />Fax 269- -762- 6'9S"y <br />APN <br />16504016 <br />EMail: <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name <br />'R AV 1 N DI'E. 5nu6- 4 <br />Title <br />0 Lo N <br />Day Phone <br />919 2-- ! !> <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0003299 <br />Mail Invoices to Account <br />Account Name CHEVRON #92033* <br />Account Balance as of 3/29/2016: $0.00 <br />Program/Element and Description <br />PAYMENT <br />New (('' tt ���^yNew Account ID: <br />MtITn§I'cVs'rbD Owner <br />/e)Account <br />MAR'2 9 ti <br /><Ci�' <br />SA ENO QUIN COUNTY <br />� ENTAL <br />Record ID Employee ID and Na LTH DEPAR-rMCNI . Status <br />1921 - HMBP-Regular-Primary Location <br />PR0521197 <br />EE0009817 - ROBERT LOPEZ <br />Active <br />2220 - SM HW GEN <5 TONSNR <br />PR0518549 <br />EE0001421 - STACY RIVERA <br />Active <br />2224 - HAZ MAT BUSINESS PLAN AUTHORIZATION <br />PR0518849 <br />EE0000000 - HAZ MAT SJC OES <br />Inactive <br />2301 - UST STATE SURCHARGE FEE <br />PRO507757 <br />EE0000451 - STEVE SASSON <br />Inactive <br />2361 - UST FACILITY <br />PR0231057 <br />EE0001421 - STACY RIVERA <br />Active <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE F <br />PR0507420 <br />EE0002670 - MUNIAPPA NAIDU <br />Inactive <br />ERSC - ELECTRONIC REPORTING STATE SURCHARG <br />PRO534556 <br />Inactive <br />Transferto <br />New Owner? <br />N <br />N <br />N <br />N <br />Y N <br />Y N <br />Y N <br />(Circle One) <br />Active/Inactve <br />Delete <br />I D <br />I D <br />A I D <br />A I D <br />I D <br />I D <br />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, 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: Date j 125 <br />Program Records to be TRANSFERED: ` $25.00 = Amount Paid—Date 3 / z a / <br />Water System to bT ANSFERED: Amount Paid Date <br />Payment Type S' - Check Number 3 G �J 1 % Received by <br />EHD Staff: / i Date ? / Account out: Date 5/__50/ 16, <br />COMMENTS: Jt, ��� n_3 /nomn e -t -F r/frr/�(� Invoice#:oc7qJO <br />
The URL can be used to link to this page
Your browser does not support the video tag.