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Date run 2/28/2012 2:56:53PK SAN Jr QUIN COUNTY ENVIRONMENTAL HE.' TH DEPARTMENT Report sso21 <br /> Run by }WI Pagel <br /> Facility Information as of 2/28/&W <br /> Record Selection Criteria: Facility ID FAC018753 <br /> Make changesicorrections in RED ink. <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 VYAI <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0018753 f I <br /> Facility Name CENTRAL SPRING INC Log <br /> Location 1616 BOEING WAY <br /> STOCKTON, CA 95206 <br /> Phone 209-983-1234 x0 <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 HIRO SUZUKI <br /> Title PLANT MANAGER <br /> Day Phone 209-983-1234 <br /> Night Phone 510-921-8056 <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 (Cede One) <br /> Account Balance as of 2/28/2012: $0.00 <br /> (Circle Dire) <br /> Transfer to Adiveflnadve <br /> ProgramlEloment and Description Record 10 Employee ID and Name Status New Owner4ate <br /> 2227-GEN 5<25 TONS PERMIT PR0529791 EE0001421 -STACY RIVERA Active Y N A I D <br /> 2244-PACT TRANSFER RECORD-DES PR0527669 Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHPRO534526 Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknoWedge that all site,and/or project specific,PHS/EHD hourly charges a h this <br /> facilay or activity vntl be billed to the Parry identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinate Codas anNor Standards and <br /> State anC/or Federal Laws, <br /> APPLICANTS 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 heck Number Recei <br /> REHS: — Date / /L�--Account out: rr Date <br /> COMMENTS: <br /> \\eh-env\envisi on\reports\502 1.rpt <br />