Laserfiche WebLink
Date run 2/17/2016 4:51:36PN SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report #5021 <br />Run by Pagel <br />Facility Information as of 2/17/2016 <br />Record Selection Criteria: Facility ID FA0009311 <br />OWNER FILE INFORMATION Number of facilities for this owner: 1 <br />Owner ID <br />OW0007311 Case Number: H03037 <br />Owner Name <br />TRILORE TECHNOLOGIES INC <br />Owner DBA <br />TRILORE TECHNOLOGIES INC <br />Owner Address <br />3000 F DANVILLE BLVD 525 <br />Y <br />ALAMO, CA 94507-1574 <br />Home Phone <br />Not Specified <br />Work/Business Phone <br />415-999-2772 <br />Mailing Address <br />3000 F DANVILLE BLVD #525 <br />A I D <br />ALAMO, CA 94507-1574 <br />Care of <br />InactivE <br />FACILITY FILE INFORMATION <br />Facility ID / CERS ID FA0009311 10182583 <br />Facility Name TRILORE TECHNOLOGIES INC <br />Location 4101 ARCH RD <br />STOCKTON, CA 95215 <br />Phone 925-890-8067 x0 <br />Mailing Address 3000 F Danville Blvd #525 <br />ALAMO, CA 94507-1574 <br />Care of Justin Collins <br />Location Code 01 - STOCKTON <br />Bos District 004 - WINN, CHARLES <br />APN 17926013 <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name <br />Title <br />Day Phone <br />Night Phone 18 ,2016 - <br />ACCOUNTS RECEIVABLE FILE INFORMATIO <br />Account ID AR0016311 Account NMENT HEALTH <br />Mail Invoices to `� —AIT/SERVICESERVICES <br />Account Name TRIL O GIES INC <br />Account Balance as of 2/17/2, 16: $320.00 7`�S9'3 <br />Program/Element and Description Record ID Employ ID— d Name <br />Make changes/corrections in RED ink. <br />INFORMATION CHANGE (date) <br />OWNERSHIP CHANGE (date) <br />SSN /Fed Tax ID <br />New Owner ID : <br />i <br />Alt Phone <br />Fax <br />EMail : <br />iu�c <br />Mail Invoices to: <br />New Account ID: : <br />Owner / Facility <br />(Circle One) <br />Account <br />(Circle One) <br />Transfer to Active/Inactve <br />Status New Owner? /Bekete <br />1- HMBP-Regular-Primary Location <br />PR0522736 IC R <br />Active <br />Y <br />N <br />Alf I <br />2220 - SM HW GEN <5 TONS/YR <br />PR0513765 EE0007289 - ALISON YOUNGBLOOD <br />InactivE <br />Y <br />N <br />A 1 D <br />2224 - HAZ MAT BUSINESS PLAN AUTHORIZATION <br />PR0511599 EE0000000 - HAZ MAT SJC OES <br />InactivE <br />Y <br />N <br />A I D <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE F <br />PRO509311 EE0000000 - HAZ MAT SJC OES <br />InactivE <br />Y <br />N <br />A I D <br />ERSC - ELECTRONIC REPORTING STATE SURCHARG <br />PRO536829 <br />Inactive <br />Y <br />N <br />A I D <br />BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site, and/or project specific, <br />PHS/EHD hourly charges associated <br />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 and/or <br />Standards <br />and State and/or <br />Federal Laws. <br />APPLICANT'S SIGNATURE: <br />Date <br />Program Records to be TRANSFERED: * $25.00 = Amount Paid Date <br />Water System to be TRANSFERED: Amount Paid Date <br />Payment Type Check Number Received by <br />EHD Staff: ice% -l2� Date l f / Account out: L45 Date 3 / 14 /1 <br />COMMENTS: <br />ReS,poy%Skble � <br />Invoice #: <br />ly\AC&. <5 -Kn a- e no kolnyr peera.VAv%� f O'ea'-Se CLd\J \&e <br />