Laserfiche WebLink
Date run 12/8/2014 9:49:29AK SAN JC. .UIN COUNTY ENVIRONMENTAL HEA,,4I DEPARTMENT Report#5021 <br /> Pagel <br /> Run <br /> M <br /> Facility Information as of 12/8/2014 <br /> Record Selection Criteria: Faality ID FA0010834 <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: 8 SSN/Fed Tax ID <br /> Owner ID OW0007438 Case Number: H03965 New Owner ID <br /> Owner Name O'Reilly Auto Enterprises, L.L.C. <br /> Owner DBA O'REILLY AUTO PARTS <br /> Owner Address 645 E MISSION AVE 194 <br /> PHOENIX, AZ 85012 <br /> Home Phone Not Specified <br /> Work/Business Phone 417-862-3333 <br /> Mailing Address 702 E. Bethany Home Road <br /> Phoenix, AZ 85014 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility lD/CERS ID FA0010834 10183857 <br /> Facility Name O'REILLY AUTO PARTS#2917 <br /> Location 3228 E HAMMER LN <br /> STOCKTON, CA 95212-2814 <br /> Phone 209-474-9960 x <br /> Mailing Address 3E Company, Regulatory Dept./O'Reilly Auto, <br /> Carlsbad, CA 92010 <br /> Care of CSK Auto, Inc. <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN 128-020-06 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 AR0017834 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name O'REI LLY AUTO PARTS#2917 (Circle One) <br /> Account Balance as of 12/8/2014: $0.00 <br /> (Circle One) <br /> Transfer to Activennaave <br /> PrograMElement and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PRO620515 EE0000006-HAZA SAEED Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PRO514431 EE0005642-MICHELLE HENRY Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO513122 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2226-CaIARP PROGRAM PRO514872 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PR0510834 EE000000G-HAZ MAT SJC DES Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO531831 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andor project specific,PI-SEI-D hourly charges associated with this faality <br /> or adivey 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 endo,Standards and State iinGbr <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: Date / I <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 Received by <br /> REHS: Date_/_/_ Account out: Date <br /> COMMENTS: <br />