Laserfiche WebLink
Date run 10/31/2014 1:15:59F SAN JO JIN COUNTY ENVIRONMENTAL HEA.' ! DEPARTMENT <br /> Run b ...r Report#5021 <br /> Y <br /> Facility Information as Of 10/31/2014 Pagel <br /> Record Selection Critena: Facility ID FA0016348 <br /> Make changesicorrections 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 OW0013228 New Owner ID <br /> Owner Name KENDRICK, HAROLD J <br /> Owner DBA LOCKEFORD AUTO <br /> Owner Address 2$2-72`E—A1C-ANTp4q_f Zo l <br /> Home Phone 209-727-0800 <br /> Work/Business Phone 209-601-5851 <br /> Mailing Address PO BOX 214 <br /> CLEMENTS, CA 95237 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0016348 10185147 <br /> Facility Name LOCKEFORD AUTO <br /> Location 12962 BLOSSOM CT <br /> LOCKEFORD, CA 95237 <br /> Phone 209-727-0800 x <br /> Mailing Address 12962 BLOSSOM CT <br /> LOCKEFORD, CA 95237 <br /> Care of HAROLD KENDRICK <br /> Location Code 99 - UNINCORPORATED P Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> APN 05131052 EMaV <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0028730 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to Owner / Facility 1 Account <br /> Account Name LOCKEFORD AUTO (Circle One) <br /> Account Balance as of 1013112014: $0.00 <br /> (Circle One) <br /> Transfer tc Activeflnactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner7' Delete <br /> 1920-HMBP-Common Materials PRO524660 EE0008709-JAMIE DE LA ROSA Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR0524371' EE0001422-ARIS VELOSO Active Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PR0524686 EE0002620-ALFONSO ARAMBULA Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO533919 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT. I,the undersigned owner,operator or agent of same,acknowledge that all site,and ar project specific,PEISIEFID hourly charges associated with INS 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 andt'of Standards and State and+or <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE' Date ! ! <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date ! F <br /> Water System to be TRANSFERED: Amount Paid Date ! 1 <br /> Payment Type Check Number Receiv d y <br /> RENS: 'ptJ Date 1 _l� Account out: Date ` ! 1 <br /> COMMENTS. <br />