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Date run 6/10/2016 11:38:58AI SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report #5021 <br />Run by Pagel <br />Facility Information as of 6/10/2016 <br />Record Selection Criteria: Facility ID FA0023509 <br />OWNER FILE INFORMATION Number of facilities for this owner: 1 <br />Owner ID OW0021779 <br />Owner Name Barry FRAIN <br />Owner DBA <br />Owner Address <br />Home Phone Not Specified <br />Work/Business Phone 209-462-0717 <br />Mailing Address 330 N Grant St <br />Stockton, CA 95202 <br />Care of <br />FACILITY FILE INFORMATION <br />Facility ID / CERS ID FA0023509 10671805 <br />Facility Name <br />con J Franke warehouse 1 <br />Location <br />330 N Grant St <br />Stockton, CA 95202 <br />Phone <br />209-462-0717 x0 <br />Mailing Address <br />330 N Grant St <br />Stockton, CA 95202 <br />Care of <br />Con J. Franke Electric, Inc. <br />Location Code <br />BOS District <br />APN <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name <br />Title <br />Day Phone <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Make changes/corrections in RED ink. <br />INFORMATION CHANGE (date) <br />OWNERSHIP CHANGE (date) <br />SSN/Fed Tax ID <br />New Owner ID : <br />Alt Phone <br />Fax <br />EMail : <br />Account ID AR0043353 <br />Mail Invoices to Account Mail Invoices to: <br />Account Name CON J FRANKE ELECTRIC INC (317) <br />Account Balance as of 6/10/2016: $0.00 <br />New Account ID: : <br />Owner / Facility / Account <br />(Circle One) <br />(Circle One) <br />Transfer to Active/Inactve <br />Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br />1921 - HMBP-Reqular-Primary Location PR0541062 EE0009817 - ROBERT LOPEZ Active Y N A I D <br />2220 - SM HW GEN <5 TONS/YR PR0541061 EE0000015 - TIMOTHY ENGLE 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 anrYor Standards and State andlor <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 by <br />EHD Staff: TVO Date (i / 10 fa Account out: CF Date <br />COMMENTS: VO —7 / <br />Invoice #: L Y <br />5 NL61'tn <br />