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Date run 8/24/2012 221:10Ph SAN JC 'UIIN COUNTY ENVIRONMENTAL REA- I DEPARTMENT Report#5o21 <br /> Run by 4( Pagel <br /> Facility information as of 8/24/2012 <br /> Record Selection Gillette: Facility ID FA0018753 <br /> Make changes/corrections in RED ink. 2N I Z <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0015420 New Owner ID <br /> Owner Name CHUO SPRING CO LTD <br /> Owner DBA CENTRAL SPRING INC <br /> Owner Address 1616 BOEING WAY <br /> STOCKTON, CA 95206 <br /> Home Phone Not Specified <br /> Work/Business Phone 118-105-2623 <br /> Mailing Address 1616 BOEING WAY <br /> STOCKTON, CA 95206 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0018753 <br /> Facility Name CENTRAL SPRING INC <br /> Location 1616 BOEING WAY <br /> STOCKTON, CA 95206 <br /> Phone 209-983-1234 xO <br /> Mailing Address 1616 BOEING WAY <br /> STOCKTON, CA 95206 <br /> Care of <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 001 -VILLAPUDUA Fax <br /> APN 17713035 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0033298 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name CHUO SPRING CO LTD (Circle One) <br /> Account Balance as of 8/24/2012: $0.00 <br /> (Circle One) <br /> Transfer to Acbvelnaclve <br /> Progra"Element and Description Record ID Employee ID and Name Status New Omen Delete <br /> 1920-HMBP-Common Materials PRO527669 EED009817-ROBERT LOPEZ Active Y N A U D <br /> 2227-GEN 5<25 TONS PERMIT PRO529791 EE0001421 -STACY RIVERA Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCH,PR0534526 Active Y N A © D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,me undersigned owner,operator or agent of same,acknowledge that all site,andlor project specific,PHSIEHD hourly charges associated with this facility <br /> or activity will be billed to the party identified as the OWNER on this form Ialso certify that all operations will be performed in accordance with all applicable Ortlinance Codes andfor Standards and State andlor <br /> Federal Laws. <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date I / <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment/Type /Check Number Receiv <br /> REHS: K q'L'/ V�� ll/'�� Date /�7 / / Account cut: Date <br /> / 27/ � <br /> COMMENTS: <br /> �� � �zo <br /> Pl <br /> �3U �1�,esf clod :�Lh-1 Za � l ��3 S � ►'L <br /> �nS^ 31 I I Q, �� 1 <br />