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Dale run 12/22/2014 10:50:44/ SAN JOAWOIN COUNTY ENVIRONMENTAL HEAI DEPARTMENT Report#5021 <br /> Run by I" Pagel <br /> Facility Information as of 12/22/2014 <br /> Recon Selection Criteria: Facility ID FA0010085 <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 OW0008085 Case Number: H06500 New Owner ID <br /> Owner Name BRIAN HYNDMAN <br /> Owner DBA AZTEC TECHNOLOGY CORP <br /> Owner Address 2550 S SANTA FE AVE <br /> VISTA, CA 92084 <br /> Home Phone Not Specified <br /> Work/Business Phone 760-727-0533 <br /> Mailing Address 2550 S SANTA FE AVE <br /> VISTA, CA 92084 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0010085 10183193 <br /> Facility Name AZTEC TECHNOLOGY CORP <br /> Location 9193 S HARLAN RD <br /> FRENCH CAMP, CA 95231 <br /> Phone 209-982-5403 x <br /> Mailing Address 2550 S SANTA FE AVE <br /> VISTA, CA 92084 <br /> Care of Aztec Technology Corp <br /> Location Code 99 - UNINCORPORATED P Alt Phone <br /> BOS District 001 -VILLAPUDUA Fax <br /> APN 19320003 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0017085 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name AZTEC TECHNOLOGY CORP (Circle One) <br /> Account Balance as of 12/22/2014: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owren Delete <br /> 1921 -HMBP-Regular-Primary Location PRO520063 EE0008709-JAMIE DE LA ROSA Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512373 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PRO510085 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO532521 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge that all site,ardor project specific,PHSIEHD hourly charges associated with this facility <br /> or activity will be billed to the party identified as the OWNER on this form. I also cartiy that all operations will be performed in accordance with all applicable Ordinance Codes andor Standard.and Slate ander <br /> Federal Laws, <br /> APPLICANTS 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 Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br />