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Dere run 12/26/2014 11:40:3& SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Run by Report#5021 <br /> Facility Information as of 12/26/2014 Pagel <br /> Record Se sell Catena: Facility ID FA0010456 <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 <br /> SSN/Fed Tax ID <br /> Owner ID OW0008456 Case Number: H08136 New Owner ID <br /> Owner Name KINDER, STANLEY K <br /> Owner DBA SIERRA CHEMICAL CO (STKN) <br /> Owner Address 1010 INDUSTRIAL DR <br /> STOCKTON, CA 95206 <br /> Home Phone Not Specified <br /> Work/Business Phone 775-358-0888 <br /> Mailing Address 2302 Larkin Circle <br /> SPARKS, NV 89431 <br /> Care of KINDER, STANLEY K <br /> FACILITY FILE INFORMATION <br /> Facility lD/CERS ID FA0010456 10183569 <br /> Facility Name SIERRA CHEMICAL CO (STKN) <br /> Location 1010 INDUSTRIAL DR <br /> STOCKTON, CA 95206 <br /> Phone 209-983-8298 x <br /> Mailing Address PO BOX 50730 �[— <br /> SPARKS, NV 89435 �ect�{o Ch O1�a10t o <br /> Care of Lanny Hammock <br /> a�OlYnri war• f urn /LYbL1 CLC�PNe OS <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 001 -VILLAPUDUA Fax <br /> APN 17728053 - EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone ,, n _ <br /> ACCOUNTS RECEIVABLE FILE INFORMATION -G��L� k��'tJ ) "" <br /> Account ID AR0017456 tri-tv(Ivp��-t� <br /> Mail Invoices to Account 0 M-)&VS'K XC Facility / Account <br /> Account Name SIERRA CHEMICAL CO(STKN) , Ch c�S)o (Cirde One) <br /> Account Balance as of 12/26/2014: $0.00 LSA roSS CMI& Circle One) <br /> ,tA�'1Zdlt <br /> l�ae am Hc��� Transfer A� �e <br /> ProgramrElement and Description Record ID Employee ID and Na New O mer Delete <br /> 1921 -HMBP-Regular-Primary Location PRO620328 EE0009817-R( Y N A I D <br /> 1963-CaIARP PROGRAM 3 FACILITY PR0535192 EE0008317-RAYMOND VON FLUE Active Y N A I D <br /> 1995-CaIARP FAC STATE SURCHARGE FEE PRO518994 EE0000000-HAZ MAT SJC DES Active Y N A I D <br /> 2220-SM HW GEN<5 TONSNR PRO518741 EE0001421 -STACY RIVERA Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO512744 EEOO00000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2226-CaIARP PROGRAM PR0514789 EE000000G-HAZ MAT SJC DES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PR0510456 EEOOOOOOO-HAZ MAT SJC DES Inactive Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PR0528832 EE0002622-BENJAMIN ESCOTTO Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0531938 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 protect specific,PHS/EHD hourly charges associated with this facility <br /> or'chvity will be billed to the party identified as the OWNER on this form I also cengy that all operations will be performed In accordance with all applicable Ordinance Codes andor Standards and Slate andor <br /> Federal Lawn <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: •$25.00= Amount Paid Date / I <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type ar_Check Number Received by <br /> A'Ylf <br /> REHS: zzMa `ZZ.dtiQ o Date / / Account out: _� Date_L/ ll.s <br /> COMMENTS: <br />