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Date run 6/16/2016 11:44:35AI SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br />Run by Pagel <br />Facility Information as of 6/16/2016 <br />Record Selection Criteria: Facility ID FA0023518 <br />OWNER FILE INFORMATION Number of facilities for this owner: 1 <br />Owner ID OW0021798 <br />Owner Name Lennox Industries Inc. <br />Owner DBA <br />Owner Address <br />Home Phone Not Specified <br />Work/Business Phone 972-497-5000 <br />Mailing Address 2100 Lake Park Boulevard <br />Richardson, TX 75080 <br />Care of <br />FACILITY FILE INFORMATION <br />Facility ID / CERS ID FA0023518 10664083 <br />Facility Name <br />Lennox Parts Plus A534 <br />Location <br />2750 CHEROKEE RD STE 4 <br />Stockton, CA 95205 <br />Phone <br />209-235-1600 x <br />Mailing Address <br />2750 Cherokee Rd Ste 4 <br />Stockton, CA 95205 <br />Care of <br />Lennox Parts Plus A534 <br />Location Code <br />—Af D L -'Oa n <br />BOS District <br />2- <br />APN <br />/3Z 0 !i0 /8 <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name <br />Title <br />Day Phone <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0043369 <br />Mail Invoices to Account <br />Account Name Richard Mosher I II <br />Account Balance as of 6/16/2016: $0.00 <br />Make changesicorrections in RED ink.�r (� V ``�� <br />INFORMATION CHANGE (date) W <br />OWNERSHIP CHANGE (date) <br />SSN/ Fed Tax ID <br />New Owner ID <br />Alt Phone <br />Fax <br />EMail : <br />Mail Invoices to: <br />New Account ID: : <br />Owner / Facility / Account <br />(Circle One) <br />(Circle One) <br />Transfer to Active/lnactve <br />Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br />11 1 <br />1921 - HMBP-Regular-Primary Location PR0541078 EE0000006 - HAZA SAEED Active Y N A I D <br />BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site, andror 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 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 b <br />EHD Staff: Date / t l0 / I(0 Account out: Date <br />COMMENTS: Invoice#: 19,9 " <br />Cie nQ,�J .irU << <br />47 <br />Yf'� ��M-vggq 0ovilli <br />