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Date we 5/11/2017 10:23:36AI SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report 11&021 <br /> Run by <br /> Facility Information as of 5/11/2017 Pagel <br /> Record Selection Criteria: Facility ID FA0010280 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 1 SSN/Fed Tax ID <br /> Owner ID OW0008280 Case Number: 7601 New Owner ID <br /> Owner Name ANDERSON, VANCE <br /> Owner DBA LYNX ENTERPRISES INC <br /> Owner Address 724 E GRANT LINE RD B <br /> TRACY, CA 95304 <br /> Home Phone 209-833-3400 <br /> Work/Business Phone 209-833-3400 <br /> Mailing Address 724 E GRANT LINE RD <br /> TRACY, CA 95304 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0010280 10183399 <br /> Facility Name LYNX ENTERPRISES INC <br /> Location 724 E GRANT LINE RD <br /> TRACY, CA 95304 <br /> Phone 209-833-3400 x <br /> Mailing Address 724 E GRANT LINE RD <br /> TRACY, CA 95304 <br /> care of ANDERSON, VANCE <br /> Location Code Aft Phone <br /> BOS District 005-ELLIOTT, BOB Fax <br /> APN 25027015 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0017280 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name LYNX ENTERPRISES INC (Circle One) <br /> Account Balance as of 5/11/2017: $0.00 <br /> (Circle One) <br /> Transfer to ActivennacNe <br /> ProgramfElement and Description Record 10 Employee 10 and Name Status New Owner? Delete <br /> 1921 -HMBP-Reqular-Primary Location PRO520916 EE0000009-NICHOLAS LOEHRER Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PRO515776 EE9999997-TWO VACANT2 Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512568 EE9999997-TWO VACANT2 Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PR0510280 EEOO00000-HAZ MAT SJC OES Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO532042 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andor project spec,PHS(EHD hourly charges associatetl with this facility <br /> or activity will be billed to the party identified as the OWNER on this form. 1 also certify that all operations will be performed in accordance with all applicable Ordinance Codes ardor Standards and Stale anclor <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 Typ .�--�_ Check Number Received by <br /> EHD Staff: �A.l.N7 �� � Date /_ :77 Amount out: ✓Date / 7 t1-7� <br /> COMMENTS: �� <br /> Invoice#: <br />