Laserfiche WebLink
Report#5021 <br /> L <br /> en 1/29/2014 10:43:06AI SAN JONass tN COUNTY ENVIRONMENTAL HEAL�EPAPagel <br /> y Facility Information as of 1/29/2014 <br /> rd Selection Criteria. Fedlity ID FA0017939 <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 OW0014735 New Owner ID <br /> Owner Name CHRISTOPHER BECKER <br /> Owner DBA AAMCO <br /> Owner Address 334 E LOCKEFORD ST <br /> LODI, CA 95240 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-986-4868 <br /> Mailing Address 334 E LOCKEFORD ST <br /> LODI, CA 95240 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0017939 10186707 <br /> Facility Name AAMCO <br /> Location 334 E LOCKEFORD ST <br /> LODI, CA 95240 <br /> Phone 209-334-5101 x0 <br /> Mailing Address 334 E LOCKEFORD ST <br /> LODI, CA 95240 <br /> Care of <br /> Location Code 02 - LODI Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> APN 04309014 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 AR0031472 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility I Account <br /> Account Name CHRISTOPHER BECKER (Circle One) <br /> Account Balance as of 1/29/2014: $0.00 <br /> (circle One) <br /> Transfer to Acbvelmactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1920-HMBP-Common Materials PR0526498 EE0008709-JAMIE DE LA ROSA Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0534324 InactivE Y N A I D <br /> aILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andor protect specific,PHSfEHD 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 ander Standards and Stale arvyor <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 T a Check Number R Y ' <br /> REHS: lL.a. Date_/�1� Account out: Date __/ <br /> COMMENTS: <br /> (� P E 22 eYD , YaLc- 0 f at. <br />