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Date run 8/20!2013 11:54:03A1 SAN JJ&UIN COUNTY ENVIRONMENTAL HEDEPARTMENT <br /> Report#5021 <br /> Run by Pagel <br /> Facility Information as of 8/20/2013 <br /> Record Selection Criteria: Facility ID FA0021024 <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 OW0017303 New Owner ID <br /> Owner Name FEDEX HOME GROUND <br /> Owner DBA FEDEX HOME GROUND <br /> Owner Address 1000 FEDEX DR <br /> MOON TOWNSHIP, PA 15108 <br /> Home Phone 412-262-7306 <br /> Work/Business Phone Not Specified <br /> Mailing Address 1000 FEDEX DR <br /> MOON TOWNSHIP, PA 15108 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility lD/CERS ID FA0021024 10,445,788 <br /> Facility Name FEDEX HOME GROUND <br /> Location 4730 FITE CT <br /> STOCKTON, CA 95215 <br /> Phone 412-262-7306 <br /> Mailing Address 4730 FITE CT IDCO <br /> STOCKTON, CA 95215 M Qc?�= It i 63 <br /> Care of ,-nuikyl)AtA VICtS <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOS District 001 -VILLAPUDUA Fax <br /> APN 18111018 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0037837 New Account ID: <br /> Mail lnvoicesto Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name FEDEX HOME GROUND (Circle One) <br /> Account Balance as of 8/20/2013: $0.00 <br /> (Circle One) <br /> Transfer to ActiveJlnadve <br /> Programlehement and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2220-SM HW GEN<5 TONSNR PRO537866 EE0001421 -STACY RIVERA Active Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO536615 EE0002620-ALFONSO ARAMSULA Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andfor project specific,PHS/EHD hourly charges associated with this facility <br /> or activity will be billed to the party identified as the OWNER on this form I also car ify that all operations will be performed in accordance with all applicable Ordinance Codes and/or Standards and Slate andor <br /> 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 Check Number Received b <br /> REHS: Date I / Account out: Date <br /> COMMENTS: <br />