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Date run 2/13/2017 1:06:31 Ph SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#6021 <br /> Ran by Facility Information as of 2/13/2017 <br /> Record Selection Criteria: Facility ID FA0009333 <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 OW0007333 Case Number: H03174 New Owner ID <br /> Owner Name C DEJONG TRUCKING INC <br /> Owner DBA C DEJONG TRUCKING INC <br /> Owner Address 24975 S AUSTIN RD <br /> RIPON, CA 95366 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-599-4187 <br /> Mailing Address PO BOX 126 <br /> RIPON, CA 95366 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0009333 10182601 <br /> Facility Name C DEJONG TRUCKING INC <br /> Location 24975 S AUSTIN RD <br /> RIPON, CA 95366 <br /> Phone 209-599-4187 <br /> Mailing Address PO BOX 126 <br /> RIPON, CA 95366 <br /> Care of <br /> Location Code 99- UNINCORPORATED P Alt Phone <br /> Bos District 005-ELLIOTT, BOB Fax <br /> APN 25724031 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 AR0016333 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name C DEJONG T KING INC (Circle One) <br /> Account Balance as of 2/13/2017: $1, .00 <br /> (Circle One) <br /> Transfer to Activielaactve <br /> PrograMElement and Description Record ID Employee ID and Name Status New Owned Delete <br /> 1921 -HMBP-Regular-Primary Locatio PRO519465 EE0000009-NICHOLAS LOEHRER Active Y N AI D <br /> 2220-SM HW GEN<5 TONS/YR PR0513774 EE9999996-THREE VACANT3 Active Y N A D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511621 EE0000000-HAZ MAT SJC DES Inactive Y N A D <br /> 2333-EXCLUDED FARM TANK PR0501244 EE0007289-ALISON YOUNGBLOOD Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PRO509333 EEOOOOOoo-HAZ MAT SJC CES Inactive Y N A D <br /> 2832-AST FAC 10 K-</=100 K GAL CUMULATIVE PR0528645 EE9999996-THREE VACANT3 Active Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PR0523732 EE0009000-HARPRIT MATTU Active Y N A D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0531764 Inactive Y N A I D <br /> �i1 G��� 121� 222p� 2S 3 �. 5��1 r�,A,c.�r��- '`� I�r►-'-�J <br />