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Date run 5/22/2009 2:21:09Pk SAN JO'—IJIN COUNTY ENVIRONMENTAL HEAI'r4 DEPARTMENT Report#5021 <br /> Run by 4006 Pagel <br /> f< t Facility Information as of 5/22/20. <br /> Record Selection Criteria: Facility ID FA0004014 <br /> Make changes/corrections in RED ink. <br /> 1 LE INFORMATION OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0002953 New Owner ID <br /> Owner Name , U.S ,&-P, feA <br /> Owner DBA BR GIL 139TERMINAL fZ- L Ila <br /> Owner Address <br /> oX ']8*I bo 9 <br /> Home Phone 2GQ.4C4_q-7Z„ —7?a7 <br /> Work/BusinessPhone 216--274-874-1- <br /> Mailing <br /> 1r; 274 ,a7Mailing Address G527 I= K40RADA I NJ <br /> nn <br /> �r/K <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0004014 0-v'J 0c'16 P`K'L L.La Ps <br /> Facility Name <br /> Location 3505 NAVY DR <br /> STOCKTON, CA 95203 <br /> Phone 2D_04.A T 7 ('71 6-) 5? <br /> Mailing Address 295 SW 41 ST STREET <br /> RENTON,WA 98055 <br /> Care of BP OIL CO/SCOTT HOOTON <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOS District 001 -VILLAPUDUA Fax <br /> APN 16203003 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name S�t E L Y Lf-talla p <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION STApT�.L %J3S1A,LZ•JG L�7f-i <br /> Account ID AR0003644 30 j-7 kl L&t< 4 STE [o L-,) New Account ID: <br /> Mail Invoices to Account //11 p n MMail^ aail Invoices to: Owner / Facility / Account <br /> Account Name 0-b RAO�A , e ` i bO C) (Circle One) <br /> Account Balance as of 5/22/2009: $0.00 S � �D�� <br /> (Circe One) <br /> Transfer to Active/Inaclve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2960-RWQCB SITE PR0009275 EE0000997-HARLIN KNOLL Active 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 Ordinace Codes and/or Standards and <br /> State 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: *$372.00= Amount Paid Date <br /> Payment T,y�ej/ Check Number Received by <br /> RENS: d lam/f1A. Date le / 01_ Account out: Date <br /> COMMENTS: <br /> \\eh-env\envision\reports\5021.rpt <br />