Laserfiche WebLink
Date nm 11/20/2017 2:38:56P SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by <br /> DONNA Facility Information as of 11/20/2017 Pagel <br /> Record Selection Cntena: Facility ID FA0010041 <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 SSN/Fed Tax ID <br /> Owner ID OW0008041 Case Number: H06315 New Owner ID <br /> Owner Name ALGER, BRENT <br /> Owner DBA AG-AIR INC <br /> OwnerAddress 5420 E DODDS RD <br /> OAKDALE, CA 95361 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-988-2567 <br /> Mailing Address 5420 DODDS RD <br /> OAKDALE, CA 95361 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0010041 10183153 <br /> Facility Name AG AIR INC <br /> Location 18417 E HWY 4 <br /> STOCKTON, CA 95215 <br /> Phone 209-465-5818 x <br /> Mailing Address 5420 DODDS RD <br /> OAKDALE, CA 95361 <br /> Care of Brent Alger <br /> Location Code 99-UNINCORPORATED A Alt Phone <br /> BOS District 004-WINN, CHARLES Fax <br /> APN 18325012 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 AR0017041 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name AG AIR INC (Circle One) <br /> Account Balance as of 11/20/2017: $535.00 <br /> (Circle One) <br /> Transfer to Activellracive <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner! Delete <br /> 1921 -HMBP-Reqular-Primary Location PR0521206 EE0008709-JAMIE LIMA Active Y N AD <br /> 2221 -USED OIL ONLY-<5 TONS/YR PR0523589 EE0000031 -ELIANNA FLORIDO Active Y N A D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO512329 EEOOO0000-HAZ MAT SJC DES Inactive Y N A D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FI PR0510041 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2830-AST FAC -SPCC EXEMPT PRO529721 EE0000027-CINDY VO Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGI PR0534455 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all sde,and/or project speck,PHSEHD hourly charges associated with this facility <br /> or activity will be billed to the partyIdent�ed as the OWNER on Nis 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 / <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date / / <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type�—ti�Check Number Re ived b <br /> EHD Staff: C ^' ' Date—J(_/ 42Z /2M Account out: Date / Z`t / �1 <br /> �COMMENTS: <br /> 1vo� opece��t 1�ne @Aun�-c� �e� rn�nec (ease - }v�lnvDice#: a4�oh� <br /> Znu�1V a�✓ 222 ?er ?VWr C Cah coil OINW. K, Ate kv.}(CI tO loofa/ a C_'hVe � <br /> address . <br />