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Date run 4/13/2018 1:58:20PIv SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 4/13/2018 <br /> Record Selection Criteria: Facility ID FA0003731 <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 OW0002772 New Owner ID <br /> Owner Name Don Precissi <br /> Owner DBA PRECISSI FLYING SVC INC <br /> OwnerAddress 11919 N LOWER SACRAMENTO RD <br /> LODI, CA 95242 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-951-1400 <br /> Mailing Address 11919N LOWER SACRAMENTO RD <br /> LODI, CA 95242 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0003731 10181357 <br /> Facility Name PRECISSI FLYING SERVICE <br /> Location 11919 N LOWER SACRAMENTO RD <br /> LODI, CA 95242 <br /> Phone 209-3694408 x <br /> Mailing Address 11919 N LOWER SACRAMENTO RD <br /> LODI, CA 95242 <br /> Care of Don Precissi <br /> Location Code 99- UNINCORPORATED A Alt Phone <br /> BOS District 004-WINN, CHARLES Fax <br /> APN 05902047 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name Paul Precissi <br /> Title Pilot <br /> Day Phone 209-369-4408 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0003310 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name PRECISSI FLYING SERVICE (Circle One) <br /> Account Balance as of 4/13/2018: $0.00 <br /> (Circle One) <br /> Transfer to Active#nacNe <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PRO519529 EE0008709-JAMIE LIMA Active Y N A 0 D <br /> 2220-SM HW GEN<5 TONS/YR PRO513761 EE0000030-AARON HANG Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511690 EEOOO0000-HAZ MAT SJC OES Inactive Y N A D <br /> 2332-EXEMPT TANK FACILITY PR0232609 EE0000030-AARON HANG Active,E Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FE PR0506666 EE0000418-MICHAEL KITH Inactive Y N A I D <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0521780 EE0000030-AARON HANG Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE PR0533194 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or 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 certify that all operations will oe performed in accordance with all applicable Ordinance Codes andfor Standards and State andfor <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, he Number Received by <br /> EHD Staff: WVV lW �,r' Date / / Account out: Date_/�/ 18 <br /> COMMENTS:no I r I n/,py, �kr "fes cn,�r.b- .I <br /> VV 41 }^/{n`� W(�i ) (.�rN, E/1(J(L� Invoice#: <br /> O 1 \ <br />