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Date run 12!2712017 1:26:32F SAN JOAQUIN COUNTV ENVIRONMENTAL HEALTH DEPARTMENT Report 95021 <br /> Run by Pagel <br /> Facility Information as of 12127/2017 <br /> Record Selection Criteria: Facility ID FA0010791 <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: 1 SSNI Fed Tax ID <br /> Owner ID OW0008791 New Owner ID <br /> Owner Name THOMPSON, JAMES E JR8it'-ra a111)Ub 10 <br /> Owner DBA AUTO SPECIALTIES <br /> Owner Address 1905 LONE FOX CT 5-r <br /> TRACY, CA 95375 u <br /> Home Phone Not Specified <br /> Work/Business Phone 209-833-3880 <br /> Mailing Address 7918 W 11TH ST <br /> TRACY, CA 95304 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility IDICERS ID FA0010791 10183823 <br /> Facility Name AUTO SPECIALTIES <br /> Location 7918 W ELEVENTH ST <br /> TRACY, CA 95304-9303 <br /> Phone 209_833-3880 x <br /> Mailing Address 7918 W 11TH ST <br /> TRACY, CA 95304 <br /> Care of JAMES E THOMPSON JR LOA)U <br /> Location Code 99 _ UNINCORPORATED A Alt Phone <br /> BOS District 005 - ELLIOTT, BOB Fax <br /> APN 25015001 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION} Yp�� <br /> TAAContact Name ` �+1•y�r tl rCD A L O O D O A) <br /> Title Rev G[1)} O <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION JOA4UIN GOUNN <br /> Account ID AR0017791 SP SWRO 4 R�F%-T New Account ID: <br /> Mail Invoices to Account Mail Invoices i Owner I Facility 1 Account <br /> Account Name AUTO S ] ,C (circle One) <br /> Account Balance as of 12/27/20 7: $472.00 T <br /> (Circle One) <br /> Transfer to Activellnactve <br /> ProgramlElement and Description Record BD Employee ID and Name Status New Owner? Delete <br /> 1920-HMBP-Common Materials PR0521185 EE0000009-NICHOLAS LOEHRER Active Y N A I D <br /> 2220-SM HW GEN<5 TONSIYR PRO514419 EE9999997-TWO VACANT2 Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO513079 EE9999997-TWO VACANT2 Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PRO510791 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0534188 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENTI,the undersigned owner,operater or agent of same,acknowledge that all site,andior project specific,PHSIEHD hourly charges associated with this facility <br /> or activity will be hillad to the party identified as the OWNER on Phis form. I also certify that all operations will be performed in accordance with all applicable Ordinance Codes andror Standards and State andlor <br /> Federal Laws_ <br /> APPLICANT'S SIGNATURE: Date 1 1 <br /> Program Records to be TRANSFERED: $25.00= Amount Paid Date 1 1 <br /> Water System to b T NSFERED: Amount O Dat 11 <br /> Payment Type Check Number 7�� Received <br /> EHD Staff: Date 1 I Account out: Date 7,7--1—.2-71 <br /> COMMENTS; <br /> Invoice#: <br />