Laserfiche WebLink
Date run 3/11/2013 2:39:23PR SAN JIN COUNTY ENVIRONMENTAL HEAW DEPARTMENT Report 95021 <br /> Run by Pagel <br /> Facility Information as of 3/11/201's <br /> Record Selection Criteria: Facility ID FA0016407 <br /> Make changestcorrections in RED ink. _ <br /> INFORMATION CHANGE(date) / <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0013280 New Owner lD <br /> Owner Name BEKINS MOVING &STORAGE <br /> Owner DBA BEKINS MOVING &STORAGE AGENTS <br /> Owner Address 334 PO BOX 334 <br /> STOCKTON. CA 95201 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-943-6683 <br /> Mailing Address 607 N WILSHIRE AVE B <br /> STOCKTON, CA 95203 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016407 <br /> Facility Name BEKINS MOVING & STORAGE AGENTS <br /> Location 607 N WILSHIRE AVE B <br /> STOCKTON, CA 95203 <br /> Phone 209-943-6683 x0 1d <br /> Mailing Address 607 N WILSHIRE AVE B <br /> STOCKTON, CA 95203 <br /> Care of <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOS District 001 -VILLAPUDUA Fax <br /> APN 13320021 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 AR0028868 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Namp gB}4l�MQVJNG& STORAGE (Circle One) <br /> Account Balance a of 3/11/2013: $1� �� ' 0 311 <br /> '',`,��11 � (Circle One) <br /> UW W��J Il p� 1�/ Transfer to ActiveJlnactve <br /> Piro ram Ele Recortl ID Employee ID and Name Status New Owner? Delete <br /> N4�9,n-HMBP-Common Materials PR052446�4 EE0009817-ROBERT LOPEZ Active Y N A I D <br /> ERSC-ELECTRONIC REPORTIal STAif tRCH)PR0533 87 0 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT. I,the undersigned owner,operator or agent of same,acknowledge that all site,anclor 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 form I also certify that all operations will be Performed in accordance with all applicable Ordinance Codes andor Standards and State andor <br /> Federal Laws <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment T e Check Number Receiv d hv <br /> REHS: �-- Date / /�,� Account out: Date <br /> � L v - L�( V C e� Cl f/l tJ1 y L(S <br /> jp� �y <br /> �x-10 �- � > <br />