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Daten 5/22/2014 :50:20PN SAN JOIN COUNTY ENVIRONMENTAL HEAL. DEPARTMENT Report#5021 <br /> '`a <br /> Run by J M Facility Information as of 5/22/2014 Pagel <br /> Record Selection Criteria: FacilitylD FA0010287 <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 OW0008287 Case Number: 7614 New Owner ID <br /> Owner Name Steve Giannecchini <br /> Owner DBA BRITZ-SIMPLOT GROWER SOLUTIONS <br /> Owner Address 3265 W FIGARDEN DR <br /> FRESNO, CA 937113906 <br /> Home Phone Not Specified <br /> Work/BusinessPhone 209-931-1571 <br /> Mailing Address PO BOX10 <br /> Linden, CA 95236 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0010287 10138541 t'1 <br /> Facility Name SGS Stockton -Jack Tone Road <br /> Location <br /> Stockton, CA 95215 <br /> Phone 209-461-6565 x <br /> Mailing Address 7707 S Jack Tone Road <br /> Stockton, CA 95215 <br /> Care of Paul Simpson <br /> Location Cade 99- UNINCORPORATED P Alt Phone <br /> BOS District 005 - ELLIOTT, BOB Fax <br /> APN 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 AR00172�8'+7 1 New Account ID: <br /> Mail Invoices to JJ C)wrlor Y' Mail Invoices to: Owner / Facility / Account <br /> ....__ 1111 ���, (Circle One) <br /> Account Name Steve Giannecchini <br /> Account Balance as of 5/22/2014: $0.00 (Circle One) <br /> Transfer to Activellnactve <br /> Program/Element and Description <br /> Record ID Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PR0521174 EE0006044-LOWELL ALLEN Active Y N A I D <br /> 1962-CalARP PROGRAM 2 FACILITY PRO530018 EE0008317-RAYMOND VON FLUE Active Y N A I D <br /> 1995-CaIARP FAC STATE SURCHARGE FEE PR0522226 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2220-SM HW GEN<5 TONSNR PR0538425 EE0009001 -ELENA MANZO Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512575 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2226-CaIARP PROGRAM PR0514757 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PR0510287 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PR0530758 EE0007379-AMANDA BOERTIEN Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0533842 <br /> Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andfor project specific,PHSFEHD hourly charges associated with this facility <br /> or activity 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 ander Standards and State aadfor <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 Ty/pee Check Number Recely <br /> REHS: 1! ` � Date_/_/_ Account out: Date <br /> COMMENTS: <br />