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ERewrd <br /> 7CHtena <br /> 0:52:41AI SAN JO.,�JIN COUNTY ENVIRONMENTAL HEAL DEPARTMENT Rcpotl#5021 <br /> Facility Information as of 1/29/2014 page, <br /> Facility ID FA0019673 <br /> Make changesicorrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0016130 New Owner ID <br /> Owner Name CARANDO TECHNOLOGIES INC <br /> Owner DBA CARANDO TECHNOLOGIES INC <br /> Owner Address 345 N HARRISON ST <br /> STOCKTON, CA 95203 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-948-6500 <br /> Mailing Address 345 N HARRISON ST <br /> STOCKTON, CA 95203 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0019673 10187299 <br /> Facility Name CARANDO TECHNOLOGIES INC <br /> Location 345 N HARRISON ST <br /> STOCKTON, CA 95203 <br /> Phone 209-948-6500 x0 <br /> Mailing Address 345 N HARRISON ST <br /> STOCKTON, CA 95203 <br /> Care of <br /> Location Code Alt Phone <br /> BOS District 001 -VILLAPUDUA Fax <br /> APN 13725021 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account 10 AR0035035 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name CARANDO TECHNOLOGIES INC (Circle one) <br /> Account Balance as of 1/29/2014: $0.00 <br /> (Circle One) <br /> Transferto Active/Inadve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owne? Delete <br /> 1921 -HMBP-Regular-Primary Location PRO529836 EE0009817-ROBERT LOPEZ Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0532498 Inactivt Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific,PHEHD hourly charges associated with this facility <br /> or activity will be,billed to the party identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinance Codes and/or Standards and State ardor <br /> Federal Laws. <br /> APPLICANT'S 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 Racial <br /> REHS: l i W&% Date /—L-t— Accountout: Date, / / Z4 <br /> COMMENTS: <br /> Pit <br /> �R©5L38'�leO <br />