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Date mn 7/7/2008 10:08:53AM SAN JO�JIN COUNTY ENVIRONMENTAL HEAL DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 7I7I200e <br /> Record Selection Criteria: Facility ID FA0010264 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0008264 Case Number: H07525 New Owner ID <br /> Owner Name VINTAGE INVESTMENTS <br /> Owner DBA SATURN OF STOCKTON <br /> Owner Address 2991 AUTO CENTER CIR <br /> STOCKTON, CA 95212 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-956-9505 <br /> Mailing Address 2991 AUTO CENTER CIR <br /> STOCKTON, CA 95212 <br /> Care of VINTAGE INVESTMENTS <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010264 <br /> Facility Name SATURN OF STOCKTON <br /> Location 2991 AUTO CENTER CIR <br /> STOCKTON, CA 95212 <br /> Plane 209-956-9505 <br /> Mailing Address 2991 AUTO CENTER CIR <br /> STOCKTON, CA 95212 <br /> Care of VINTAGE INVESTMENTS <br /> Location Code 01 -STOCKTON Alt Phone <br /> SOS District 003- MOW, VICTOR Fax <br /> APN 12802017 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> roe <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0017264 New Account ID <br /> Mail Invoices to Facility Mail Invoices to: Owner I Facility / Account <br /> Account Name SATURN OF STOCKTON (Circle one) <br /> Account Balance as of 7/7/2008: $0.00 <br /> (Circle One) <br /> Transfer to Actwellnaclve <br /> Progrann(Element and Desorption Record ID Empbyee ID and Name Staea New Owner? Delete <br /> 2220-SM HW GEN<5 TONS/YR PR0514259 EE0004636-GARRETT BACKUS Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512552 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-DES PR0520181 EE0000000-HAZ MAT SJC DES Active Y N A 1 D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARPRO510264 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO522827 EE5555555-Garrett Alias-Backus Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned getter,operator or agent of same,acknowledge trial au site,and/or project specific.PHS/EHD taunt charges associated with this <br /> facility or activity we be baed to the party identified as the OWNER on this form. 1 also certify that all operations will be peRormed in accordance with as applicable Ordinace Codes andlor Standards and <br /> State anNor Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: -*$372.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS'. <br /> Uphs-ehsq)-n tlapps\envisions\reports\5021.rpt <br />