Laserfiche WebLink
Date run 5/12/2015 8:26:37AR SAN JOIN COUNTY ENVIRONMENTAL HEA67 DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 5/12/20 <br /> Record Selection Criteria Facility ID FA0001553 <br /> Make changeslcorrections in RED ink. <br /> INFORMATION CHANGE(dale) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 4 SSN/Fed Tax ID <br /> Owner ID OW0000762 New Owner ID <br /> Owner Name WENDYS OF THE PACIFIC <br /> Owner DBA WENDYS OF THE PACIFIC <br /> Owner Address 1308 KANSAS AVE 6 <br /> MODESTO, CA 953511530 <br /> Home Phone 209-577-6690 <br /> Work/Business Phone 209-577-6690 <br /> Mailing Address 1308 KANSAS AVE STE STE 6 <br /> MODESTO, CA 95351-1530 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0001553 10180777 <br /> Facility Name WENDYS (MARCH LANE) <br /> Location 2439 W MARCH LN <br /> Stockton, CA 95207 <br /> Phone 209-478-8273 x <br /> Mailing Address 1308 KANSAS AVE STE 6 <br /> MODESTO, CA 95351 <br /> Care of WENDYS OF THE PACIFIC <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOS District 002 - MILLER, KATHERINE Fax <br /> APN 11222049 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name KYNE, DIANE-BOOKKEEPER <br /> Title <br /> Day Phone 209-577-6690 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0004727 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name WENDYS OF THE PACIFIC (Circle One) <br /> Account Balance as of 5/12/2015: $0.00 <br /> (Circle One) <br /> Transferto Active/Inal <br /> Progra"Elemenl and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1626-RESTAURANT/BAR 101 +SEATS PRO160187 EE0006213-VIDAL PEDRAZA Active Y N A I D <br /> 1921 -HMBP-Regular-Primary Location PRO520751 EE0000006-HAZA SAEED Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0513495 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PR0511207 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0531619 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 spec,PHSrEHD 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 angor Standards and State ender <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 />