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Date run 6/29/2018 4:07:49PN SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br />Run by Pagel <br />Facility Information as of 6/29/2018 <br />Record Selection Criteria: Facility ID FA0005481 <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 : 40 <br />Owner ID <br />OW0000353 <br />Owner Name <br />MANTECA, CITY OF <br />Owner DBA <br />MANTECA, CA 95337 <br />OwnerAddress <br />1001 W CENTER ST <br />Mailing Address <br />MANTECA, CA 95337 <br />Home Phone <br />209-239-8455 <br />Work/Business Phone <br />209-456-8468 <br />Mailing Address <br />1001 W CENTER ST <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGI <br />MANTECA, CA 95337 <br />Care of <br />CITY OF MANTECA <br />FACILITY FILE INFORMATION <br />Facility ID / CERS ID FA0005481 10181845 <br />Facility Name <br />MANTECA CORP YARD <br />Location <br />210 E WETMORE ST <br />2218 - CRT HANDLER <br />MANTECA, CA 95337 <br />Phone <br />209-456-8440 <br />Mailing Address <br />1001 W CENTER ST <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FI <br />MANTECA, CA 95337 <br />Care of <br />Location Code 04 - MANTECA <br />Bos District 005 - ELLIOTT, BOB <br />APN 21938313 <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name DAVID BRICKER <br />Title CHIEF OF POLICE <br />Day Phone 209-456-8139 <br />Night Phone 209-239-8401 <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0006011 <br />Mail Invoices to Facility <br />Account Name MANTECA CORP YARD <br />Account Balance as of 6/29/2018: $0.00 <br />Program/Element and Description Record ID <br />1921 - HMBP-Reqular-Primary Location <br />PR0519882 <br />2217 -APPLIANCE RECYCLER <br />PR0521301 <br />2218 - CRT HANDLER <br />PR0521302 <br />2224 - HAZ MAT BUSINESS PLAN AUTHORIZATION <br />PR0512095 <br />2228 - GEN 25<50 TONS PERMIT <br />PR0521300 <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FI <br />PR0509807 <br />4423 - REFUSE VEHICLES (1-25 VEHICLES) 4 HR MIN <br />PR0440022 <br />4740 - WASTE TIRE SITE - EXEMPT <br />PR0524165 <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGI <br />PR0533389 <br />SSN / Fed Tax ID <br />New Owner ID : <br />Alt Phone <br />Fax <br />EMail : <br />New Acco u nt I D: : <br />Mail Invoices to: Owner / Facility / Account <br />(Circle One) <br />Employee ID and Name <br />EE0000009 - NICHOLAS LOEHRER <br />EE9999997 - TWO VACANT2 <br />EE9999997 - TWO VACANT2 <br />EE9999997 - TWO VACANT2 <br />EE9999997 - TWO VACANT2 <br />EE0000000 - HAZ MAT SJC OES <br />EE0004680 - NATALIA SUBBOTNIKOVA <br />EE0002622 - BENJAMIN ESCOTTO <br />(Circle One) <br />Transfer to <br />Activellnactve <br />Status <br />New Owner? <br />Delete <br />Active <br />Y <br />N <br />A <br />I D <br />Active <br />Y <br />N <br />A <br />CI _> D <br />Active <br />Y <br />N <br />A <br />I D <br />Inactive <br />Y <br />N <br />A <br />I D <br />Active <br />Y <br />N <br />A <br />I D <br />Inactive <br />Y <br />N <br />A <br />I D <br />Active <br />Y <br />N <br />A <br />I D <br />Inactive <br />Y <br />N <br />A <br />I D <br />Inactive <br />Y <br />N <br />A <br />I D <br />