Laserfiche WebLink
Report#5021 <br /> ERuh <br /> run 3/9/2017 1:45:40PM SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Paget <br /> Facility Information as of 3/9/2017 <br /> Record Selection Criteria: Facility ID FA0010264 <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: 1 SSN/Fed Tax ID <br /> Owner ID OW0008264 Case Number: H07525 New Owner ID <br /> Owner Name Lithia Motors <br /> Owner DBA <br /> Owner Address 150 N BARTLETT CIR <br /> MEDFORD, OR 92501 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-955-3181 <br /> Mailing Address 150 N Bartlett St <br /> Medford, OR 97501 <br /> care of LITHIAAUTO STORES <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0010264 10183381 <br /> Facility Name Volkswagen of Stockton <br /> Location 2991 AUTO CENTER CIR <br /> STOCKTON, CA 95212 <br /> Phone 209-242-9700 x <br /> Mailing Address 2991 AUTO CENTER CIR <br /> STOCKTON, CA 95212 144 4 <br /> Care of Volkswagen of Stockton <br /> Location Code 01 -STOCKTON Aft Phone <br /> BOS District 003 - BESTOLARIDES, STEVE Fax <br /> APN 12802017 Eli l: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0017264 New Account ID: <br /> Mail Invoices to Account Mail Invoices to. Owner / Facility / Account <br /> Account Name Volkswagen tockton _� (Circle One) <br /> Account Balance as of 3/9/2017: $5 .00 ,A }�.VrLIJ <br /> y,y(y ` (circle ono) <br /> -1 V Transferto Adivaflnactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PRO520181 EE0008709-JAMIE LIMA Active Y N A D <br /> 2220-SM HW GEN<5 TONSNR PR0514259 EE0001459-VICKI MCCARTNEY Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO512552 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FI PR0510264 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2840-AST EXEMPT FAC <1,320 GAL PRO528219 EE0000006-HAZA SAEED Inactive Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO522827 EE0009000-HARPRIT MATTU Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE PR0534262 Inactive Y N A 1 D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andor project specific,PHSIEHD hourly charges associated with this facility <br /> or activity will be billed to the party identified as the OWNER on this rem,. I also certify that all operetions will be performed in accordance with all applicable Ordinance Codes ander standards and Stale endar <br /> 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 TyCheckCheck Number Received by <br /> EHD Staff: l 1�/1M I,r r,,A /' .{Date �t / _/�/���ttA/ccouunntttoout: IA�J Date �✓l 1 aJ/ l <br /> �Ub�N�S 1e0 WlNAN �� Q t2t11� W� �S _ �r� ' Invoice#: <br />