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Date run_ 5/3/2011 2:21:23PM SAN 3(. rJIN COUNTY ENVIRONMENTAL HES I DEPARTMENT Report M21 <br /> Page t' <br /> Run by 4006 Facility!Information as of 513120 <br /> Record selection Criteria: Facility 1D FA0009637 <br /> Make changeslcafrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> F0 I LOWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION i SSN 1 Fed Tax ID :. <br /> Owner ID OW0007637 New Owner ID <br /> Owner Name LODUCA,VINCENT P JR <br /> Owner DBA VPL TRANSPORT INC <br /> Owner Address 11199 N HWY 99 <br /> LODI, CA 95240 <br /> Home Phone 209-644-2303 <br /> iWork/Business Phone 209-644-2307� Mailing Address -Pe BG_lE-OGID;.- C 60-Y, 1 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009637 <br /> Facility Name VPL TRANSPORT INC <br /> Location 11199 N HWY,99 <br /> LOD I, CA 95240 <br /> Phone 209-3643-1369 <br /> Mailing Address RA-f3 )X 6401, �f <br /> -Care of <br /> Location Code 99- UNINCORPORATED R Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> 1 LAME <br /> APN 05914064 EMail: <br /> I EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone 209-369-1369 <br /> Night Phone 209-644-2303 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account.ID AR0016637 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner 1 Facility I' Account <br /> Account Name VPL TRANSPORT INC (Circle one) <br /> r <br /> Account Balance as of 51312011: $887:50 <br /> (Circle One) <br /> Transfer to "veltnactve <br /> ProgranVElement and Description Record ID Employee ID and Name Status New Owner?. Delete <br /> 2220-SM'HW GEN c5 TONS/YR PRO523404 EE0001422-ARIS CACAPIT Active Y 'N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPR0511925 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-OES PRO519791 EE0060000-HAZ MAT SJC OES Active Y N A I D <br /> 2399_UNIFIED PROGRAM FAC STATE SURCHARIPR0509637 EE0000000-HAZ MAT SJC OES Inactive Y N -A i D <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATKPR0528242 lE. EE0001422-ARI S' CACAPIT Active Y N -A I D <br /> 4740-WASTE TIRE SITE-'EXEMPT - v PR0524068 EE0007379-AMANDA BOERTIEN Active Y N A .'I D <br /> t ERSC-ELECTRONIC REPORTING STATE SURCHPRO534203 Active Y N A I D <br /> f <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific.PHSIEHD hourly charges associated with this <br /> facility 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 Ordinate Codes and/or Standards and <br /> State andlor Federal Laws. <br /> APPLICANT'S SIGNATURE: f h A I.L P-C-AA AY3 Oe- L Z-- Date ! 1 f <br /> Program Records to be TRANSFERED: "$25.00= Amount Paid Date I I <br /> y Water System to be TRANSFERED: Amount Paid Date 1 I <br /> Payment Type Check Number Received.by <br /> REHS: Date 1 1 Account out: Date 11 l <br /> COMMENTS: <br /> 11eh-L!nvlen visionlreports15021.rpt <br /> i <br />