Laserfiche WebLink
Daterun 2/9/2017 2:32:11PM SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Rayon a5e21Rage1 <br /> Run by • DONNA Facility Information as of 2/9/2017 <br /> Record Selection Cdtena. Facility ID FA0020341 <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 to OW0016699 New Owner ID <br /> Owner Name Dynamic Textile Restoration, Inc <br /> Owner DBA CODE 3 CLEANERS <br /> Owner Address 4527 S B ST <br /> STOCKTON, CA 95206 <br /> Home Phone 925-980-4241 <br /> Work/Business Phone 925-980-4241 <br /> Mailing Address 4527 South B Street <br /> STOCKTON, CA 95206 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS 10 FA0020341 10187567 <br /> Facility Name CODE 3 CLEANERS <br /> Location 1588 E MARCH LN <br /> STOCKTON, CA 95210 <br /> Phone 209-952-6333 x <br /> Mailing Address 4527 South B Street <br /> STOCKTON, CA 95206 <br /> Care of Stephen Crotty <br /> Location Code 01 -STOCKTON Alt Phone <br /> Bos District 002 - MILLER, KATHERINE Fax <br /> APN 09614022 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 AR0036328 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name CODE 3 CLEANERS (Circle One) <br /> Account Balance as of 2/9/2017: $2,707.90 <br /> (Circle One) <br /> Trsnsferlo Active/InecNe <br /> PmgraMElemem and Description Record ID Employee ID and Name Status New Owned Delete <br /> 1921 -HMBP-Regular-Primary Location PR0535226 EE0008709-JAMIE LIMA Active Y N A D <br /> 2220-SM HW GEN<5 TONS/YR PRO539238 EE0001459-VICKI MCCARTNEY Active Y N A D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0535291 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned Owner,operator or agent of same,acknowledge that all site,an&or project specific,PHSIEHD hourly charges associated with this facility <br /> or activity will be billed to the party identriied as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinance Codes anclor Standards and State anNor <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 Recei —7 <br /> EHD Staff: Date / / Account out: Date <br /> COMMENTS: <br /> Mal\ renC.(gs1� �sg49� <br /> l�orr e �n�Lc es -CO.L tlt y � �aS2 adv Ise <br />