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Date run 2/5/2008 3:36:05PM SAN JO ' �U1N COUNTY ENVIRONMENTAL HEAT^'Z DEPARTMENT Report x5021 <br /> Run by 4006 Pagel <br /> Facility Information as of 2/5/20Do"'f <br /> Record Selection Criteria: Facility ID FA0009828 <br /> FILEMake chaAncil. <br /> E INFORMATION CHANGE(date) <br /> i�� OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0007828 Case Number: H05564 New Owner ID : <br /> Owner Name RICHARD D AYRES <br /> Owner DBA PISKEL'S AUTO AIR RAD &CELLUL <br /> Owner Address , M CL4. <br /> Home Phone Not Specified <br /> Work(Business Phone 209-524-7535 <br /> Mailing Address 264-- A1yE' . <br /> 99 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility I FA0009828 <br /> Facility Name <br /> pISKEL'S AUTO AIR RAD&CELLULAR <br /> Location 264 BUTTON AVE <br /> MANTECA, CA 95336 <br /> Phone 209-239-0884 <br /> Mailing Address 9.64_ll ITTON G1yP - <br /> 5 <br /> Care of <br /> Location Code 04- MANTECA APN:20831004 <br /> BOS District 005-ORNELLAS, LEROY SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016828 New Account ID: <br /> Mail Invoices to ,Gwp j. Mail Invoices to: Owner Facility / Account <br /> Account Name RICHARD D AYRES ne) <br /> Account Balance as of 2/5/2008: ' 237-60' <br /> (Circle One) <br /> Transfer to Aclivennadve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2220-SM HW GEN<5 TONS/YR PR0514052 EE0002670-MUNIAPPA NAIDU -AOr t- Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512116 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-DES PR0519897 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARPRO509828 EE0000000-HAZ MAT SJC DES 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/or project specific,PHS/EHD hourly charges associated with this <br /> facility or actio"ay WWI be billed to the party identified as the OWNER on this fans. I also certify that all operations will be performed in accordance with all applicable Ordinace Codes and/or Standards and <br /> State and/or Federal Laws. nn �-�A ^ \\ ,r� 7 <br /> APPLICANT'S SIGNATURE: YMty- 4;"r-4) -/, �V tt1-70�/ Date �7 �/ d <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 Received b} P' <br /> REHS: Date / / Account out: Ham-- Date 2- <br /> COMMENTS: <br /> ow A)e4L / P-tC-t't yam, <br /> \\phs-ehsql-nt\apps\envisions\reports\5021.rpt <br />