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Dale nun 10/2/2014 11:00:40AI SAN JOIN COUNTY ENVIRONMENTAL HEALOEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 10/2/2014 <br /> Record Selection Criteria: Facility ID FA0021924 <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: 5 SSN/Fed Tax ID : <br /> Owner ID OW0008924 Case Number: H08981 New Owner ID <br /> Owner Name AutoZone Stores Inc <br /> Owner DBA AUTO ZONE <br /> Owner Address 123 S FRONT ST <br /> MEMPHIS, TN 381033607 <br /> Home Phone Not Specified <br /> Work/Business Phone 901-495-6500 <br /> Mailing Address 123 South Front Street <br /> Memphis, TN 38103 <br /> Care of PECORD, PHIL <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0021924 10457440 <br /> Facility Name AutoZone#6217 <br /> Location 941 W March Ln <br /> Stockton, CA 95207 <br /> Phone 209-473-3714 x <br /> Mailing Address Dept 8190, 123 South Front Street <br /> Memphis, TN 38103 <br /> Care of Kimsan Sok <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOS District 002 - RUHSTALLER, LARRY 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 AR0039951 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name AutoZone#6217 (Circle One) <br /> Account Balance as of 10/2/2014: $0.00 <br /> (Circle One) <br /> Transfer to Activelinactve <br /> Program/Element and Description Record ID Employee ID and Name Stews New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PR0539313 EE0000006-HAZA SAEED Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR0537978 EE0000005-FATINAH ZAREEF Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,anclor 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 certify that all operations will be performed in accordance win all applicable Ordinance Codes ander Standards and State and <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 />