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Date run 1119/2017 8:53:19AN SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 11/9/2017 <br /> Record Selection Criteria: Facility ID FA0023518 <br /> Make changeslcorrections in RED ink. <br /> INFORMATION CHANGE(date) �Irt-17t <br /> OWNERSHIP CHANGE(date) : <br /> OWNER FILE INFORMATION Number of facilities for this owner: 1 SSN/Fed Tax ID <br /> Owner ID OW0021798 New Owner ID <br /> Owner Name Lennox Industries Inc. <br /> Y: <br /> Owner DBA <br /> OwnerAddress 2100 LAKE PARK BLVD <br /> RICHARDSON, TX 75080 <br /> Home Phone Not Specified <br /> Work/Business Phone 972-497-5000 <br /> Mailing Address 2100 Lake Park Boulevard <br /> Richardson, TX 75080 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0023518 10664083 <br /> Facility Name LENNOX PARTS PLUS A534 <br /> Location 2750 CHEROKEE RD STE 4 <br /> STOCKTON, CA 95205 <br /> Phone 209-235-1600 x <br /> Mailing Address 2750 Cherokee Rd Ste 4 <br /> Stockton, CA 95205 r1 /I /' <br /> Care of Lennox Parts Plus A534 <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOIS District 002-MILLER, KATHERINE Fax <br /> APN EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title 1 <br /> Day Phone I <br /> Night Phone \ <br /> Qi <br /> ACCOUNTS RECEIVABLE FILE INFORMATION r Ci <br /> Account ID AR00433E C� ` New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name Richard Mosher 1 — � (Circle One) <br /> Account Balance as of 11/9/2017: $404 <br /> CV1tFY (Circle One) <br /> .1 AlTransfer to ActiveAnactve <br /> Program/Element and Description Retard ID Employee ID and Name Status New Owner! Delete <br /> 1921 -HMBP-Reqular-Primary Location PR0541078 EE0009817-ROBERT LOPEZi-6_5 <br /> e Y N A 0D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT'. I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project spec,P SIEHD hourty 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 andor Standards and State andor <br /> Federal Lars. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Tyre— <br /> Check Number Received by <br /> EHD Staff: �� Date / /q-1 /-:;7 Account out: Date ;Li- /_E7 <br /> COMMENTS: <br /> / g f Invoice#: <br /> 4)0 h �0.✓�{ o S 6^-c '� �r/ w C4 /1` C3 (�. - S r <br />