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Date run 9/7/2010 9:17:11AM SAN Jf_ IUIN COUNTY ENVIRONMENTAL HE;" 'H DEPARTMENT Report 95021 <br /> Run by Pagel <br /> Facility Information as of Qf7M.v' <br /> Record Selection Criteria: Facility ID FA0020481 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0016826 New Owner ID <br /> Owner Name HONDO COMPANY LLC <br /> Owner DBA <br /> Owner Address PO BOX 1218 <br /> WOODBRIDGE, CA 95258 <br /> Home Phone 209-369-8255 <br /> Work/Business Phone Not Specified <br /> Mailing Address PO BOX 1218 <br /> WOODBRIDGE, CA 95258 <br /> Care of DIEDE, STEVE L <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0020481 <br /> Facility Name,HION A {f!)A1 r-, COMPAV CLC- <br /> Location 1123 E VINE ST <br /> LODI, CA 95240 <br /> Phone 209-369-8255 <br /> Mailing Address PO BOX 1218 <br /> WOODBRIDGE, CA 95258 <br /> Care of LEE, ROBERT <br /> Location Code 02 - LODI Alt Phone <br /> BOS District 004-VOGEL, KEN Fax <br /> APN 04915006 EMail : <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name ROBERT LEE <br /> Title <br /> Day Phone 209-369-8255 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0036623 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name HIONDO COMPANY LLC (Circle One) <br /> Account Balance as of 9/7/2010: $0.00 A <br /> ( ) (Circle One) <br /> v Transfer to Ac[ive/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2832-AST FAC 10 K-</=100 K GAL CUMULATIVEPRO535525 EE0001422-ARIS CACAPIT Active Y N A � D <br /> ERSC-ELECTRONIC REPORTING SURCHARGE PR0535527 Active Y N 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,PHS/EHD 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 Ordinace Codes and/or Standards and <br /> State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: 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 Receive <br /> REHS: !:�` Date / / + Account out: Date OR <br /> COMMENTS: <br /> \\eh-env\envision\reports\5021.rpt <br />