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Dalalle) 4!23/20'13 •10:56:13AI SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT ncpoiIrtsoa,t <br />lxun by- .- � 1Ap fannet <br />f=acility Information as of 4123/2013 <br />Record Selection Criteria: r•tt:illly, ID FA0007088 <br />OWNER FILE INFORMATION <br />Owner ID OW000582.1 <br />Owner Narne TESORO REFINING, MKTG & SUPPLY <br />Owner DBA - <br />Owner Address 3003 NAVY DR <br />STOCKTON, CA 95206 <br />Home Phone Not Specified <br />WOfWBUSineSs Phone 253-896-8700 <br />Mailing Acid rails 3003 NAVY DR <br />STOCKTON, CA 95206 <br />Care of <br />FACILITY FILE INFORMATION <br />Facility ID t CERS ID FA0007088 '10,182,187 <br />Facility Name TESORO VVES T COAST COMPANY <br />Location 3003 NAVY DR <br />STOCKTON, CA 95206 <br />Phone 209-466-8800 <br />Matte changoslcorrections in RED Ink. <br />INFORMATION CHANGE_ (date) <br />OWNERSHIP CHANGE (date) <br />SSN / Fed Tar. ID <br />New Owner ID : <br />Tesoro Logistics LLC <br />leave Blank <br />1.9100 <br />San Antonio, TX 78259 <br />210 626994. <br />Stockton Terminal �. .. <br />Mailing Address 3003 NAVY DR <br />STOCKTON, CA 95206 <br />Care of PAUL BRUSS <br />Location Code 01 •. STOCKTON Alt Phone, <br />ROS District 001 - VILLAPUDUA Fax _ <br />APN 14503009 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 AR0010256 <br />New Account ID:: <br />_—— <br />Mail Invoices to Facility <br />Mail Invoices to: Owner / Facility l <br />Account <br />Account Name ; <br />5(0CCm4 ,m wt NkG (Circle Otte) <br />Account Balance as of 4/23/2013: 90.00 <br />(Circle 011e) <br />I ranter to <br />Activeflnactve <br />PronmmlElement and Description Recon! If) <br />Fmployee ID and Name. Slabs Nene Owner') <br />Delete <br />1921 - HMSP-Regular-Primary Location PRO519480 <br />EE0009817 - ROBERT LOPEZ Active Y N <br />N <br />A 1 D <br />A I D <br />2.224 - HAZ- MAT BUSINESS PLAN AUTHORIZATIOIPR0511521 <br />EE0000000 - HAZ MAT S.1C OES Inactive Y <br />2228 - GEN 25<50 TONS PERMIT PRO505927 <br />EE0001421 - STACY RIVERA Active Y N <br />A I D <br />A I D <br />2231 - HAZARDOUS WASTE PBR FACILITY PR0519134 <br />EE0001421 - STACY RIVERA Inactive Y N <br />I D <br />2332 - EXEMPT TANK FACILITY PR0231837 <br />EF_0001421 - STACY RIVERA Active,Exempt Y N <br />A <br />I D <br />2.399 - UNIFIED PROGRAM FAC STATE SURCHARtPR0,507653 <br />EE0000451 -STEVE SASSON Inactive Y N <br />YN <br />A <br />2834 - AST FAC 1 M •1 1 - <l=10 M GAL CUMULATIVPR0516435 <br />FE0001421 -STACY RIVERA Active <br />A I D <br />�• c <br />ERS(- ELECTRONIC REPORTING .NATE SURCI-4129 <br />Inactive <br />Fill I IN(; and COMPI IANCF ACKNOWI RnGI:NII'NT 1, me nn(W'Signnd n:•u­ <br />.,r ;,00nl .)f sanw, eekt..Wcdnn Ih;a all sJe, anctnt rmiart spec fu:, r'HfJGMD hourly charges assoaalilawdh tills iscriny <br />loaned ir. aC: ordanre sri:6 all nppticzoie Ordinance Cortes an(Voi Slanlards and Slide arbor <br />or mualy will be odlod to the, party idenllhen n , ;he CAPPIRR on this fnrm I nilten ,;: �:::. <br />a C7erelli815 vdll Ce net <br />Federal i_' 's 2) <br />APPLICANT'S SIGNnTUR'i-: <br />Program Records to be TRA1J$f='.-*R?I1 ,--_—_-, nn <br />Amount Cafc1 <br />Water System to be'I'13nI:<;1.71. -RI':D <br />Amount Paul <br />PaymentTypr: —0hi:!ritNow1wI <br />R�:ceivefi/L�j — -- <br />Date <br />REI.IS: _ =; <br />I Account out' —!�/` <br />COM1,041 S� n <br />(Z <br />