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f <br /> Dale run 1/24/2011 12:15:51PI SAN JOl^UIN COUNTY ENVIRONMENTAL AEAI I DEPARTMENT Recon x5021 <br /> Run by 5290 Pagel <br /> Facility Information as of 1/24/20�T <br /> Record Selection Criteria: Facility ID FA0010111 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0008111 New Owner ID <br /> Owner Name VALLEY TRANSPORT SERVICES INC <br /> Owner DBA <br /> Owner Address (05'00 LtaJQ <br /> STOCKTON, CA 95206-4R2-B' <br /> Home Phone Not Specified <br /> Work/Business Phone 209-462-8700 <br /> Mailing Address 6500 LINDBERGH ST <br /> STOCKTON, CA 952064928 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010111 1/ALL.t,-( 7aA&VPa A:Z <br /> Facility Name y tr )%q_GA o <br /> Location 7030 S C E DIXON ST <br /> STOCKTON, CA 95206 <br /> Phone 209-462-8700 <br /> Mailing Address 6500 LINDBERGH ST <br /> STOCKTON, CA 952064928 <br /> Care of <br /> Location Code 99- UNINCORPORATED P Alt Phone <br /> BOS District 001 -VILLAPUDUA Fax <br /> APN 17726026 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name BILL ROWE <br /> Title <br /> Day Phone 209-327-2500 Cell <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0017111 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name Y€6E^.:^:-CSB• Ja.L�L( *SPL (Circle one) <br /> Account Balance as of 1/24/2011: $0.00 <br /> (Circle One) <br /> Transfer to Adivennadve <br /> Program/Element and DescriptionRecord ID Employee ID and Name Status New Owner? Delete <br /> `:2220-SM HW GEN<5 TONS/YR PRO514174 EE0002670-MUNIAPPA NAIDU Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512399 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-OES PR0520874 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARPR0510111 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING SURCHARGE PRO533398 Active 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 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 Ordinace Codes and/or Standards and <br /> State and/or 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 Type Check Number Receiv <br /> REHS: Date / / Account out: d Date 1 / IJ-f / I <br /> COMMENTS <br /> \\eh-env\envision\reports\5021.rpt <br />