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Report 95021 <br /> Date run 5/4/2009 3:19:49PM SAN JQ�� IN COUNTY ENVIRONMENTAL HEA,#DEPARTMENT Pagel <br /> Ren by Facility Information as of 50! <br /> . 1 <br /> Record Selection Criteria: Facility ID FA0011236 <br /> Make changeslcorrections in RED ink. <br /> INFORMATION CHANGE(date) �-- <br /> OWNERSHIP CHANGE(date) -- <br /> SSN/Fed Tax ID <br /> OWNER FILE INFORMATION New Owner ID <br /> owner ID OW0009236 Case Number: H09507 <br /> Owner Name UNITED RENT LS NORTHWEST INC �v <br /> Owner DBA UNITED RENTALS INC MAv <br /> Owner Address 5 GREENWICH OFFICE PARK <br /> GREENWICH, CT 06831 SAN <br /> Home Phone Not Specified OF EMEesc U� <br /> Work/Business Phone 203-622-3131 -cnVICES <br /> Mailing Address 3818 RHONDA WAY <br /> TRACY, CA 9f 304 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0011236 <br /> Facility Name UNITED RENTALS NORTHWEST INC <br /> Location 3818 RHONDA WAY <br /> TRACY, CA 95376 <br /> Phone 209-832-1200 XO <br /> Mailing Address 38481R1i6M0A*QVAY S( n 5 b <br /> Care of Alt Phone <br /> Location Code Fax <br /> BOS District 005-ORNEL S, LEROY Email: <br /> APN 21225010 <br /> EMERGENCY NOTIFICATION CONTACT I FORMATION <br /> Contact Name RON HARMON <br /> Title <br /> Day Phone 209-832-120 <br /> Night Phone 1< ci,� <br /> ACCOUNTS RECEIVABLE FILE INFORMATION L k CrT d New Account ID: <br /> Account lD AR0018236 Mail invoices to: Owner / Facility I Account <br /> Mail Invoices to Owner '� (circle One) <br /> Account Name UNITED RENTALS NORTHWEST INC <br /> Account Balance as of 5/412009: $0.00 (Circle ono) <br /> TarWer to Active/InacNe <br /> Record ID Employee ID and Name <br /> Status New Owner? Delate <br /> Progam/Element and Description Y N A D <br /> 2220-SM HW GEN<5 TONSIYR PR0524361 EE0005642-MICHELLE HENRY Active Y N A D <br /> 2224.HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO513524 EE0000000-HAZ AT SJC OES Inactive Y N A I D <br /> 2244.PACT TRANSFER RECORD-OES PRO520769 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARIPR0511236 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATAPR0528618 EE0005642-MICHELLE HENRY Active Y N A I o <br /> 1 PR0524696 EE0000060-JENNIFER FRASE Inactive <br /> 4740-WASTE TIRE SITE-EXEMPT c.PHS1EHD hourly charges ociated <br /> facility or activityCMPlLI billedEA he WLOANCCKNOEdanEME as the OWundersigned NER on his formowner I aPlso ceratorrilryor agent of same.acknomedge that all lhat all operations wiII bas performed int accordance projvAect <br /> all appp1licable Ordinece Code andlorsstandardstand s <br /> BILLING andwIl <br /> arty <br /> State and/or Federal Lars. ` �\{ <br /> APPLICANTS SIGNATURE: Se e a \ u ` A Date <br /> 20.00= Amount Paid Date�_—I--- <br /> Program Records to be TRANSFERED: $ Date <br /> $372.00= Amount Paid <br /> Water System to be TRANSFERED: Received by <br /> Payment Type Check Nu ber N—C— Date_I <br /> Date—_I--I-- Account out: <br /> REHS: <br /> COMMENTS: <br /> \\eh-env\envision\reports\5021.rpt <br />