Laserfiche WebLink
Daly con 2/17/2009 3:55:12PM SAN Jf 2UIN COUNTY ENVIRONMENTAL HE. 'H DEPARTMENT Report#5021 <br /> Run by 5290 1� ✓ Pagel <br /> Facility Information as of 2/17/2009 <br /> Record Selection Criteria: Facility ID FA0017914 <br /> Make changes/corrections in RED ink or pe <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW 0014712 New Owner ID <br /> Owner Name BAYANZAY, HAM <br /> Owner DBA A+ SMOG & REPAIR <br /> Owner Address 2357 MEADOWBROOK DR <br /> LODI, CA 95242 <br /> Home Phone 209-943-9000 <br /> Work/Business Phone Not Specified <br /> Mailing Address 2357 MEADOWBROOK DR <br /> LODI, CA 95242 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017914 <br /> Facility Name A+ SMOG & REPAIR <br /> Location 930 E CHARTER WAY STE A <br /> STOCKTON, CA 95205 <br /> Phone 209-943-9000 <br /> Mailing Address 930 E CHARTER WAY STE A <br /> STOCKTON, CA 95205 <br /> Care of HAJI BAYANZAY <br /> Location Code 01 -STOCKTON Aft Phone <br /> BOS District 001 - GUTIERREZ, STEVE Fax <br /> APN 16718303 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name HAJI BAYANZAY <br /> Title <br /> Day Phone 209-943-9000 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0031411 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name A+ SMOG & REPAIR (circle One) <br /> Account Balance as of 2/17/2009: $687.00 <br /> cirde One) <br /> Transfer to AcUveMecive <br /> Program/FJamem and Description Record ID Employee ID and Name Status New Owners $e <br /> 2220-SM HW GEN<5 TONS/YR PRO526465 EE0008317-RAYMOND VON FLUE Active Y N A 1 D <br /> BILLING aid COMPLVWCE ACKNOWLEDGEMENT: I.the undesslgned owner,operator or agent of same,acknowledge that ail site,and/or protect spedfic.PHS/EHD hourly charges associated this <br /> facility a activity will be billed to Me party identlfied as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinace Codes anal$Slanderds and <br /> State ardlerr Federal laws. <br /> APPLICANT'S SIGNATURE: Date / / <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date / / <br /> Water System to be TRANSFERED: •$372.00= Amount Paid Date <br /> Payment Check Number Recei <br /> REHS: tl��8 Date Account out: Date / l� <br /> COMMENTS: <br /> F orc„ YS C("5 <br /> Plea , <br /> tleh-enNenvisicnx1502 .rpt <br />