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Date run 7/21/2015 9:57:46Afv SAAQUIN COUNTY ENVIRONMENTAL I- ,TH DEPARTMENT Report#5021 <br /> Run by 19 <br /> Facility Information as of 7/21/2015 Pagel <br /> Record selection Criteria: Facility ID FA0002232 <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: 14 SSN/Fed Tax ID : <br /> Owner ID OW0000478 New Owner ID <br /> Owner Name QUIK STOP MARKETS INC <br /> Owner DBA <br /> OwnerAddress 4567 ENTERPRISE ST <br /> FREMONT, CA 94538 <br /> Home Phone Not Specified <br /> Work/Business Phone 510-657-8500 <br /> Mailing Address 4567 ENTERPRISE ST <br /> FREMONT, CA 94538-7605 <br /> Care of QUIK STOP MARKETS INC <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility ID/CERS ID FA0002232 10180893 <br /> Facility Name QUIK STOP MARKET#3132* <br /> Location 3555 W HAMMER LN <br /> STOCKTON, CA 95209 <br /> Phone 209-951-3195 x <br /> Mailing Address 4567 ENTERPRISE ST <br /> FREMONT, CA 94538-7605 <br /> Care of NACHHATAR SIDHU & RUSE VENDER KAUf <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 003 - BESTOLARIDES, STEVE Fax <br /> APN 071-180-20 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> contactName DHILLON, BALBIL <br /> Title <br /> Day Phone 209-951-3195 <br /> Night Phone 209-951-3195 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0002245 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name QUIK STOP MARKET#3132* (Circle One) <br /> Account Balance as of 7/21/2015: $0.00 <br /> (Circle One) <br /> Transfer to ActiveMactve <br /> Program/Element and DescAption Recom ID Employee ID and Name Status New Owner? Delete <br /> 1617-RETAIL MARKET> 1000 SO FT W/FOOD PREP PRO160303 EE0001084-STEPHANIE RAMIREZ Active Y N A I D <br /> 1921 -HMBP-Regular-Primary Location PRO519800 EED000006-HAZA SAEED Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PRO526835 EE0000005-FATINAH ZAREEF Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO511935 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2301 -UST STATE SURCHARGE FEE PR0515541 EE0000418-MICHAEL KITH Inactive Y N A I D <br /> 2361 -UST FACILITY PR0231130 EE0000005-FATINAH ZAREEF Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FI PR0507297 EE0000418-MICHAEL KITH Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGI PR0532154 Inactive Y N A I D <br />