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Date run 3/21/2013 10:18:32A1 SAN J IN COUNTY ENVIRONMENTAL HE DEPARTMENT Report#5021 <br /> Run by � Pagel <br /> Facility Information as of 3/21/201 <br /> Record Selection Criteria: Facility ID FA0005359 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) / <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0004205 New Owner ID <br /> Owner Name AMAN -KENNETH--LEE }ib4��L1 - ('ItaLi� iJ �1rJ� E(�t� U1t-1✓A� <br /> Owner DBA KALENDS AUTO WRECKING f1:2i Pt lLlY1 �G,If <br /> Owner Address 8237 E HWY 26 _STIX k'Ii hJ r to �iS11 <br /> STOCKTON, CA 95215 <br /> Home Phone 209,-403-2332. f .2t r1) "i Sts' - i t 1 5 <br /> Work/Business Phone 209-931-0929 <br /> Mailing Address 8237 E HWY 26 <br /> STOCKTON, CA 95215 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility 10/CERS ID FA0005359 10,181,807 <br /> Facility Name KALENDS AUTO WRECKING <br /> Location 8237 E HWY 26 <br /> STOCKTON, CA 95215 <br /> Phone 209-931-0929 <br /> Mailing Address 8237 E HWY 26 <br /> STOCKTON, CA 9521.15 r <br /> Care of K€NAICTLI--LETE-AA4AN— <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 002- RUHSTALLER, LARRY Fax <br /> APN 10113072 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name KENNETH LEE AMAN PAYMENT 4-tVWA, �aAL.'JhrJ� <br /> Title RG`.i4 <br /> Day Phone 209-931-0929 E\ ED <br /> Niot-Phone 2es�aas-23�—eell tv .: �. 'L 1 2013 n-1 I <br /> couN <br /> ACCOUNTS RECAccouBt DLE EICE INFORMATION SAN:301k MEN EP11e New Account ID: <br /> AR0005821 HEALTH OX <br /> Mail Invoices to Facility Mail Invoices to: Owner Iacility Account <br /> KI <br /> Account Name KALENDS AUTO WRECN P/L conal <br /> Account Balance as of 3/21/ 13: $O.0f . <br /> n .JV r (Circle Ona) <br /> 'FJ —lV Transfer to Activelete e <br /> ProgreMElemenl and Description � Record ID Employee ID and Name Status New OvmeYt Delete <br /> 2220-SM HW GEN<5 TONSNR PRO529505 EE0009488-JEFFREY WONG Active Y N A 1 D <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0502198 EE0000451 -STEVE SASSON Inactive Y N A 1 D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523892 EE0002622-BENJAMIN ESCOTTO Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCH,PR0532439 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge that all site,and/or protect specific,PHS/EHD hourly charges associated with this facility <br /> or activity will be billed to the party identified as the OWNER on this fom. I also certify that all operations will be performed in accordance with all applicable Ordinance Codes andor Standards and Stale and'a <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: �'� {�� o -n Date �jl _l <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid a5_ Date -- l-0511l [ n <br /> Water System to be TRANSFERED: Amount Paid Dat /_/ <br /> Payment Type ) Check Number Reoeiv I <br /> REHS: 1n DatelD/7_ Account out: <br /> 7 L� Date NT/ Zip <br /> COMMENTS: z).7 <br />