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Date run 7/10/7.013 10 38:41AI SANJUIN COUNTY ENVIRONMENTAL HE,*DEPARTMENT Report#5021 <br /> Run by 1. - Pagel <br /> Facility Information as of 7110/2013 <br /> Record Selection Criteria: Facility ID FA0018160 <br /> Make changes/corrections in RED Ink. _Cd <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0014903 New Owner ID <br /> Owner Name ARMOR STRUXX <br /> Owner DBA ARMOR STRUXX LLC <br /> Owner Address 500 S BECKMAN RD <br /> LODI, CA 95240 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-371-8000 <br /> Mailing Address 500 S BECKMAN RD <br /> LODI, CA 95240 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0018160 10,186,811 <br /> Facility Name ARMOR STRUXX LLC <br /> Location 500 S BECKMAN RD <br /> LODI, CA 95240 <br /> Phone 209-371-8000 <br /> Mailing Address 500 S BECKMAN RD <br /> LODI, CA 95240 <br /> Care of ALLEN AARON <br /> Location Code 02- LODI Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> APN 04931018 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name JIB �tNcl><�Z <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0031930 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name ARMOR STRUXX (CimleOne) <br /> Account Balance as of 7/10/2013: $0.00 <br /> (Circle One) <br /> Transfer to Aclivellnactve <br /> Program/Element antl Description Record 10 Employee ID and Name Status New Owner? Delete <br /> 1921 -HMSP-Regular-Primary Location PR0526803 EE0008709-JAMIE DE LA ROSA Active Y N A I D <br /> 2227-GEN 5<25 TONS PERMIT PR0534802 EE0001422-ARIS CACAPIT Active Y N A I D <br /> 3 -EXEMPT TANK FACILITY PR0536287 EE0001422-ARIS CACAPIT Active,l Y N A (7) D <br /> 31 -AST FAC >/= 1,320-<10 K GAL CUMULATIVE PR0536059 EE0001422-ARIS CACAPIT Active,l Y N A `-r D <br /> ERS -ELECTRONIC REPORTING STATE SURCHARG PR0534639 Inactive Y N A I D <br /> BILLING end COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,anNor project specific,PHS/EHD hourly charges associated with this facility <br /> oractivity will bebilled to the party itlentified es the OWNER on mis form also certify that all operations will be performed in accordance with all applicable Ordinance Codes andlor Standards and State an6'or <br /> Federal Lews. <br /> Nb W UVS rrr► sr��ve <br /> APPLICANTS SIGNATURE: Date / I <br /> Program Records to be TRANSFERED: •$25.00= Amount Paid Date II <br /> Water System to be TRANSFERED: Amount Paid Date ! / <br /> Payment Type —_ Check Number Received by <br /> REHS: Date=/ tV /j_,�_ Account out: Date_/ / <br /> COMMENTS: <br /> �v� 16l 3 �� o•r�17�61� RE. 2331— <br />