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~ . <br /> Date rurr 2/13/2014 11:48:57AI SAN JC UIN COUNTY ENVIRONMENTAL HEA' I DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 2/13/2014 <br /> Record Selection Criteria: Facility ID FA0004175 <br /> Make inRED ink. <br /> INFORMATION CHANGE(uam) <br /> OWNERSHIP CHANGE(dam) <br /> OWNER FILE INFORMATION GGw/Fed Tax m � <br /> Owner ID Oyy0001047 New Owner|o � <br /> Owner Name T|K| LAGUN PARTNERS LLC <br /> Owner DBA T|K\ LAGUN RESORT & MARINA <br /> Owner Address 6243 EMBARCADERO DR <br /> STOCKJON, CA 95210 <br /> Home Phone 209-601-4538 <br /> vvom/BuoinnooPhono 208-484-2980 <br /> Mailing Address 6248-EK88ARGf\8ER&OR- ��p/6\ �� k� <br /> 8T0 C—KT0 C-A--05210 <br /> ' <br /> Care of <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility|o/cERa|o FA0004175 10.181.603 <br /> Facility Name T|K| LAGUN RESORT& MARINA <br /> Location 12988VVK8CDDNALO RD <br /> STOCKTON. CA 95206 <br /> Phone 209-404-2980 <br /> Mailing Address 3628'VV^HAMW1ER-tht—SU[[E-D- <br /> GTOCNTQNrCA-95219 <br /> Care of T|K| LAGUN PARTNERS LLC <br /> Location Code 99- UN|NCORPORATED,8 Alt Phone <br /> ooaoim,im 003 - BESTOLAR|DEG Fax <br /> APN 13102026 EMui|: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name F/X#(415)456'5250 <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0004255 New Account ID: � <br /> Mail Invoices m Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name TI KI LAGUN RESORT &MARINA (Circle One) <br /> Account Balance aaof2/13C2O14: $1.238.00 <br /> (Circle One) <br /> � r==* m °"~°="=� <br /> p�n�=e/°="mand o""��"" Record ID Employee mand Name ow*" New Owner? o°/*" <br /> 1616 RETAIL MARKET<1OOOGQFTVV/FOOD PREP PR0160928 ssOnu1^zo'MELISSA N|GG|M Active Y w x | o <br /> 1e21 -HMoP'neou|ar-P,imary Location PR0519572 ss0008709 JAMIE DELAROSA Active Y w A | o <br /> czzo SM HvxGEN xuTowa/vn pn0528550 se0001421 'aTAov mvEm* Active v N x | o <br /> 2e2 PR0511642 sEOn0000O'HAZMAT oxCnsS |nuouiv( Y w A | D <br /> f Pn023167e sEoono41o'MICHAEL mT* |nacui� v w A | o <br /> y����;��>P��o���F���r�T�\��nC+Anosp pno509354 Es000rcon'AuoowvouwosLOOo |noouivi v m x | o <br /> 2832'AoTFAc 1om'</~1nnuGAL CUMULATIVE Pn0516680 ss0001421 'aTAuYnmsmA Active v w * | o <br /> 4740 WASTE TIRE SITE EXEMPT pnu000000 ssusoosos'Garrett Alias-Backus |nact|vE v w A | o <br /> sRac'ELECTRONIC REPORTING STATE aURoHAno PR0534038 moctiv, Y w x | o <br /> 4633 TwoWATER SYSTEM vvA04e0583 ssoon000a'ADRIENNE sua^suaen Active v w x | o <br />