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Date run §/17/2008 7:27:58AN SAN J ZUIN COUNTY ENVIRONMENTAL HE H DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 6/17/2008 <br /> Record Selection Criteria: Facility ID FA0018907 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0015549 New Owner ID <br /> Owner Name CECCHINI, JASON W <br /> Owner DBA <br /> Owner Address 9846 S WHISKEY SLOUGH RD <br /> STOCKTON, CA 95206 <br /> Home Phone 209-547-0636 <br /> Work/Business Phone Not Specified <br /> Mailing Address 9846 S WHISKEY SLOUGH RD <br /> STOCKTON, CA 95206 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0018907 <br /> Facility Name CECCHINI TRUCKING <br /> Location 9846 S WHISKEY SLOUGH RD <br /> STOCKTON, CA 95206 <br /> Phone 209-547-0636 <br /> Mailing Address 9846 S WHISKEY SLOUGH RD <br /> STOCKTON, CA 95206 <br /> Care of CECCHINI, JASON W <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN 13110001 EMail : <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name JASON W CECCHINI <br /> Title <br /> Day Phone 209-547-0636 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0033621 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name CECCHINI TRUCKING (Circle One) <br /> Account Balance as of 6/17/2008: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? e <br /> Lfacility <br /> 2NM-AST FAC >/=1,320-<10 K GAL CUMULATI\PR0527886 EE0000001 -LINDA TURKATTE Active Y N I <br /> NG and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific,PHS/EHD hourly c ges associated with this <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 Ordinace des and/or Standards and <br /> and/or Federal Laws. <br /> �I�PV /ivq�1&C L <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: *$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: *$372.00= Amount Paid Date <br /> Payment Type Check Number !�f <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br /> k117 <br /> \\phs-ehsql-nt\apps\envisions\reports\5021.rpt <br />