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Date run 7/2/2014 8:36:24AM SAN JOIN COUNTY ENVIRONMENTAL HEALODEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 7/2/2014 <br /> Record Selection Criteria Facility ID FA0009201 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 1 SSN/Fed Tax ID <br /> Owner ID OW0007201 Case Number: H01955 New Owner ID : <br /> Owner Name NORMAN NOCK IMPORTED CARS INC <br /> Owner DBA BRITISH CAR SPECIALISTS <br /> Owner Address 2060 N WILSON WAY <br /> STOCKTON, CA 95205 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-948-8767 <br /> Mailing Address 2060 N WILSON WAY <br /> STOCKTON, CA 95205 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0009201 10182507 <br /> Facility Name BRITISH CAR SPECIALISTS <br /> Location 2060 N WILSON WAY <br /> STOCKTON. CA 95205 <br /> Phone 209-948-8767 x <br /> Mailing Address 2060 N WILSON WAY <br /> STOCKTON, CA 95205 <br /> Care of Sheila Huggins <br /> Location Code 99 - UNINCORPORATED,8 Alt Phone <br /> BOS District 002 - RUHSTALLER, LARRY Fax <br /> APN 11714043 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 AR0016201 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name BRITISH CAR SPECIALISTS (Circle One) <br /> Account Balance as of 7/2/2014: $0.00 <br /> (Circe One) <br /> Transfer to AcWelnactve <br /> Progra"Element and Description Remold ID Employee ID and Name Status New Ovmer? Delete <br /> 1921 -HMSP-Regular-Primary Location PR0519457 EE0000006-HAZA SAEED Active Y N A I D <br /> 2220-SM HW GEN<5 TONSNR PR0513697 EE0009488-JEFFREY WONG Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511489 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PRO509201 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 3122-STORMWATER INSPECTION-AUTO SHOP PR0522988 EE0009488-JEFFREY WONG Inactive Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PR0523643 EE0007379-AMANDA BOERTIEN Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0531979 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andfor 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 andfor Standards and State andfor <br /> Federal Lewis. <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 Type Check Number Received by <br /> RENS: Date_/_/ Account out: Date <br /> COMMENTS: <br />