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Date mn 7/26/2004 10:41:17AI SAN J#IN COUNTY ED;YIRO)MMENTAL HEDEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 7/26/ d <br /> Record Selection Criteria: Facility ID FA0009268 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNER FILE INFORMATION OWNERSHIP CHANGE(date) <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 New Account 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 7/26/2004: $1,368.00 <br /> (Circle one) <br /> Transfer to Activennacive <br /> Program/Element and Description Record ID Employee ID and Name Status New Owneo Delete <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PR0511556 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-OES PR0519506 EE0000000-HAZ MAT SJC DES Active Y N A I D <br /> 99-UNI P GR K FAC STATE SERVICE FPR0 6Q,_ EEOOOOOO�HAZ MATS JC DES Inactive Y N A I D <br /> EUS/ 1 o�c.�47r4�Laf— <br /> BI NG an OMPLIANCE AC OWLEDGEMENT: I,the undersign er,oD or agent o same, ckno�v0edge that all site,and/or project specific,PHS/EHD hourly charges associated vnth this <br /> facility or activity vnll be billed to the party identified as the OWNER on this form. I also certify mat all operations vall be performed in accordance with all applicable Ordinace Codes and/or Standards and <br /> Slate and/or Federal Laws. <br /> APPLICANT'S 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 /Z / a Account out: Date <br /> COMMENTS: qOil <br /> -- <br /> \\Phs-ehsgl-nt\apps\Envisions\Reports\5021.rpt VA <br />