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Dae nP1 12/92016 3:58:23PM SAN JOAQUIN COUNTY ENVIRONMENTAL <br /> Run by IFFF AT.TH DEPARTWNT Rrowl a i <br /> Facility Information as of 12/92016 <br /> Recer45tlpmpr,Qkwla F llfy lD FA0004500 <br /> Make ehanges/eoneceoms In RED Ink. <br /> INFORMATION CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 7 <br /> S /Fed Tax ID OWNERSHIP CHANGE(date) <br /> Owner ID pyU0D03415 New <br /> Owner ID <br /> Owner Name Valley Crest Companies Anen ;P `4� <br /> Owner DEA VALLEY CREST TREE COMPANY Pyi,t <br /> Owner Address 28915 FUNCK RD K .i <br /> ' ' 9%" "'Q 'Ey-gWv <br /> FARMINGTON, CA 95230 ` <br /> Home Phone Not Specified Z;w, E, <br /> York/Business Phone 209-8WS511 <br /> Mailing Address 26915 FUNCK RD <br /> FARMINGTON,CA 95230 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA00045M 10181639 <br /> Facility Name VALLEY CREST TREE COMPANY <br /> Location 28915 FUNCK RD <br /> FARMINGTON,CA 95230 <br /> Phone 209-886-5511 X _ <br /> Mailing Address 28915 funk mad <br /> farmington,CA 95230 <br /> Care of Emory Chow O <br /> Location Code 99-UNINCORPORATED ARE Aft Phone <br /> BOS District 004-WINN, CHARLES ���/// Fax <br /> APC — r/ EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0004182 New Acetum ID: <br /> Mail Inwivs to Account Mad Invoices to: Owner / F Amoum <br /> Acmunf Name EMORY CHOW IGetle a.> <br /> Account Balance as of 12192016: $0.00 <br /> Icpem ones <br /> PmgrmVElementaM Eke aeon Rapr4l0 Fmpbyee lD aml Neme c Tranahrm AG.aNnam�e <br /> New Pmefl Debre <br /> 1958-HM-Farm Operations PRO525793 EE0002670-MUNIAPPA NAIDU Active Y N A I D <br /> 2220-SM HW GEN c5 TONS/YR PRO530613 EE0001421-STACY RIVERA Alive Y N A I D <br /> 2830-AST FAC -SPCC EXEMPT PRO530612 EE000DO27-CJNDYVO Inactive Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO535353 EEOW90DO-HARPRIT MATTU Arbor Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FEE PROS34157 Inactive Y N A I D <br /> 4630-NTNC WATER SYSTEM WA0461343 FE0000003-VANCE WONG Active Y N A I D <br /> 81UJNG&w COMPWWCEACI(NOY4EDGHAENi;I,me uMrnlpnnf owner,upemlwwapem of Slime,emanedga mat ellLb,alarorprryee SpetlAS PHa�EHO lawty tluagaseandelM wlm iNsiwltly <br /> FeeadiMty�sbe pelMmPre poly laeneneE azmaOm�J,EpsRr�an wsform lNm oertlytlm ap wll be peRomad In Ne�v4m ell aPPllopWa Omliwla CaEmP aww$Ientlem5 en4 GUH andb <br /> APPLICANTS SIGNATURE 0, <br /> Program Records to be TRANSFERED: '$25.00 Amount Paid Daps Y / <br /> Water System to be TRANSFERED: Amount Pakl Daps j , / <br /> Payment Type / CtteUr Number Revived b / <br /> EHD Staft 01tegty /_� .✓ Account out: Date�/ <br /> comes is: <br /> ',a-- OIN Invakv#. <br /> INA '4t 5 "ky " tk:� vin "­yL <br />