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Date run 9/22/2004 2:40:20PR SAN J UIN COUNTY ENVIRONMENTAL HESH DEPARTMENT Report 85021 <br /> Run by Pagel <br /> Facility Information as of 9/22/2004 <br /> Record Selection Criteria: Facility ID FA0009268 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0007268 Case Number: H02631 New Owner ID : <br /> Owner Name GARY SCANNAVINO <br /> Owner DBA CHEROKEE FREIGHT LINES (TRUCK <br /> Owner Address <br /> Home Phone Not Specified <br /> Work/BusinessPhone 209-931-3574 <br /> Mailing Address 5463 E CHEROKEE RD <br /> STOCKTON, CA 95215 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009268 <br /> Facility Name CHEROKEE FREIGHT LINES <br /> Location 5463 E CHEROKEE RD <br /> STOCKTON, CA 952151120 <br /> Phone 209-931-3574 <br /> Mailing Address 5463 E CHEROKEE RD <br /> STOCKTON, CA 952151100 <br /> Care of <br /> Location Code 99 - UNINCORPORATED AREA APN:087-121-43 <br /> BOS District 002-MARENCO, DARIO SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016268 NewA000unt ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name CHEROKEE FREIGHT LINES (Circle One) <br /> Account Balance as of 9/22/2004: $0.00 <br /> (Circle one) <br /> Transfer to Active/lmctve <br /> Program/Element and Description Record ID Employee ID and Name Status New Omen Delete <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PRO511556 EE0000000-HAZ MAT SJC DES Active Y N A I D <br /> 2227-GEN 5<25 TONS PERMIT PR0513737 EE0003580-MICHELLE LE Active Y N A I D <br /> 2244-PACT TRANSFER RECORD-DES PR0519506 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE FPR0509268 EE0000000-HAZ MAT SJC DES 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 <br /> facility 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 Ordinate Codes and/or Standards and <br /> State and/or Federal Laws. <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: •$155.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br /> \\nhs-.haul-nt\anne\onvieinne\rnnnrte\Sn91 mt <br />