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Date run 4/19/2016 9:31:53AR SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report 95021 <br />Run by Pagel <br />Facility Information as of 4/19/2016 <br />Record Selection Criteria: Facility ID FA0019708 <br />OWNER FILE INFORMATION Number of facilities for this owner <br />Owner ID <br />OW0016165 <br />Owner Name <br />RYAN LOONEY <br />Owner DBA <br />CENTRAL CALIF RAILCAR REPAIR <br />Owner Address <br />2390 PORT RD <br />STOCKTON, CA 95203 <br />Home Phone <br />Not Specified <br />Work/Business Phone <br />209-465-2236 <br />Mailing Address <br />PO BOX 31062 <br />STOCKTON, CA 95213-1062 <br />Care of <br />FACILITY FILE INFORMATION <br />Facility ID / CERS ID FA0019708 10473790 <br />Facility Name Central California Railcar Repair, LLC <br />Location 2390 PORT RD M <br />Stockton, CA 95203 <br />Phone 209-465-2236 x <br />Mailing Address PO Box 31062 <br />Stockton, CA 95213-1062 <br />Care of RYAN LOONEY <br />Location Code 01-STOCKTON <br />Bos District 001 - VILLAPUDUA, CARLOS <br />APN <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name <br />Title <br />Day Phone <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0035070 <br />Mail Invoices to Account <br />Account Name VERONICA BARRY <br />Account Balance as of 4/19/2016: $377.00 <br />Program/Element and Description <br />Make changes/corrections in RED ink. <br />INFORMATION CHANGE (date) ( lP <br />OWNERSHIP CHANGE (date) <br />SSN/Fed Tax ID <br />New Owner ID : <br />Alt Phone <br />Fax <br />EMail : <br />Record ID Employee ID and Name <br />Mail Invoices to: <br />New Account ID: : <br />Owner / Facility / <br />(Circle One) <br />Account <br />(Circle One) <br />Transfer to Active/Inactve <br />Status New Owner? Delete <br />1921 - HMBP-Reqular-Primary Location PR0529871 EE0009817 - ROBERT LOPEZ Active Y N AG D <br />ERSC - ELECTRONIC REPORTING STATE SURCHARG PR0533838 Inactive Y N A I D <br />BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site, and/or project specific, PHS/EHD hourly charges associated with this facility <br />or activity will be billed to the party identified as the OWNER on this farm. I also certify that all operations will be performed in accordance with all applicable Ordinance Codes and/or Standards and State and/or <br />Federal Laws. <br />APPLICANT'S SIGNATURE: <br />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 />EHD Staff: 1,q.4.,- 2-- Date _/��l / Account out: Date <br />COMMENTS: <br />Invoice #: <br />