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I; <br /> Date run 4/7/2014 11:54:25AM SAN JO. JIN COUNTY ENVIRONMENTAL HEAL=DEPARTMENT Report#5021 <br /> Rut by Pagel <br /> Facility,lnformation as of 4/7/2014 <br /> it Record Sereaion Criteria: Facility-ID FA0015754 <br /> Make changesfcorrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> a OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 4 SSNI Fed Tax ID <br />+ Owner ID OW0011619 New Owner tD <br /> Owner Name JAMIE WILLIAMS <br /> Owner DBA .-STOCKTON RECYCLING &TRANSFER <br /> Owner Address 1533 WATERLOO RD, <br /> STOCKTON, CA 95205 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-598-5309 <br /> Mailing Address 2435 E WEBER AVE <br /> STOCKTON, CA 95205 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0015754 10,185,021 <br /> Facility Name STOCKTON RECYCLING &TRANSFER STA <br />{.. Location 401 S LINCOLN ST . <br /> i STOCKTON, CA 95203 <br /> Phone 209-943-6613 x0 <br /> Mailing Address 1533 E WATERLOO RD <br /> j STOCKTON; CA 95205 <br /> a <br /> Care of <br /> Location Code Alt Phone <br /> BOS District Fax <br /># APN .14703003 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> t Title <br /> i Day Phone <br /> Night`Phone <br /> I ACCOUNTS RECEIVABLE FILE INFORMATION <br /> r Account ID AR0027286 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner 1 Facility / Account <br /> Account Name JAM I E WILLIAMS r (Circle One) <br /> Account Balance as of 41712014: $578.00 W ►4►fi.- ZZ) (3 <br />{ (Cirde One) <br /> t <br /> Transfer to Activellnactve <br /> ProgranVEtement and Description Record ID Employee ID and Name Status New Owner? "Delete <br /> i', <br /> i 11921 -HMBP-Regular-Primary Location PRO523325 EE0009817-ROBERT LOPEZ Active Y N A I D <br /> 2220-SM HW GEN<5 TONSNR PR0528801 8ED001421 -STACY RIVERA Active Y N A I D <br /> 2840-AST EXEMPT FAC <1,320 GAL PRO528800 EE0001421-STACY RIVERA Active,l Y N A ! D <br /> c ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO533990 f Inactive Y N A I D <br /> is <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of.same,acknowledge that all site,and/or project specific,PH&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 andlor Standards and State andtor <br />} Federal Laws. <br /> APPLICANT'S SIGNATURE: � � � r -- Date 1 1 <br /> l Program Records to be TRANSFERED: "$25.00= Amount Paid: Date I / <br /> Water System to be TRANSFERED: Amount Paid Date ! 1 <br /> Payment Type Check Number Received by <br /> REBS: Date- _I2 _I Account out: _ y- Date 1�1 <br /> COMMENTS: <br /> A <br /> a <br />