Laserfiche WebLink
Dale run 2/15/2011 3:31:46PK SAN JOP'NUIN COUNTY ENVIRONMENTAL HEAI TV DEPARTMENT Report#5021 <br /> Run byPagel <br /> Facility Information as of 2/15/204T- <br /> Record Selection Criteria: Facliry ID FA0009876 <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 OW0007876 Case Number: H05707 New Owner ID <br /> Owner Name ZULIM, JOHN; SARSTED, PAUL <br /> Owner DBA <br /> Owner Address 324 N CLUFF AVE <br /> LODI, CA 95240 <br /> Home Phone 209-368-7070 <br /> Work/Business Phone 209-334-6332 <br /> Mailing Address 324 N CLUFF AVE <br /> LODI, CA 95240 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009876 <br /> Facility Name J P AUTOWORKS & SMOG <br /> Location 324 N CLUFF AVE <br /> LODI, CA 95240 <br /> Phone 209-334-6332 <br /> Mailing Address 324 N CLUFF AVE <br /> LODI, CA 95240 <br /> Care of ZULIM, JOHN; SARSTED, PAUL <br /> Location Code 02- LODI Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> APN 049-080-70 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name JOHN ZULIM <br /> Title <br /> Day Phone 209-334-6332 <br /> Night Phone 209-368-7070 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016876 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner I Facility / Account <br /> Account Name ZULIM,JOHN; SARSTED, PAUL (Circle one) <br /> Account Balance as of 2/15/2011: $262.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Omer? Delete <br /> 222 M HW GEN<5 TONS/YR PRO514075 EE0001422-ARIS CACAPIT Active Y N A CI D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512164 EE00o0000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-DES PR0519932 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARiPRO509876 EE0000000-HAZ MAT SJC DES Inactive Y N A 1 D <br /> -ELECTRONIC REPORTING SURCHARGE PR0534664 Active Y N A Q 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 activiry will be billed to the party identified as the OWNER on this farm. I also certify that all operations will be performed in accordance with all applicable Ordinace Codes anwor Standards and <br /> State andior Federal Laws. <br /> l NPM GIe-�t� <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 Check Number Rem e <br /> REHS: Aq <br /> Z Date Account out: Date / I <br /> COMMENTS: <br /> \\eh-env\envision\reports\5021.rpt <br />