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Date run 1/5/2006;42c5opM <br /> SAN JOIN COUNTY ENVIRONMENTAL HEA*DEPARTMENTReport#5021 <br /> Run byFa6lity Information as of 1/5/2006Pagel <br /> VP <br /> RecoM Selection Criteria: ility ID FA0015465 <br /> ME Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNER FILE INFORMATION OWNERSHIP CHANGE(date)►� <br /> Owner ID OW0000925 New Owner ID <br /> Owner Name STONE BROS AND ASSOCIATES <br /> Owner DBA <br /> Owner Address 1024 W ROBINHOOD# 1 <br /> STOCKTON, CA 95207 <br /> Home Phone 209-478-1791 <br /> Work/Business Phone Not Specified <br /> Mailing Address 1024 W ROBINHOOD#1 <br /> STOCKTON, CA 95207 <br /> Care of STONE BROS <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015465 <br /> Facility Name FORMR MONTGOMERY WARDS AUTO SR\ <br /> Location 5400-5606 PACIFIC AVE <br /> STOCKTON, CA 95207 <br /> Phone 209-478-1791 <br /> Mailing Address 1024 W ROBINHOOD DR#1 <br /> STOCKTON, CA 95207 <br /> Care of STONE BROTHERS <br /> Location Code 01 -STOCKTON APN 10227008 <br /> BOS District 002- MARENCO, DARIO SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0026684 New Account ID: <br /> Mail Invoices to Account `` I ` Mail Invoices to: Owner / Facility / Account <br /> Account Name ENSR^V 5 429 4-tt4c�0.� 're Cana v „ r (Circle one) <br /> Account Balance as of 1/5/2006: $102.30 UY <br /> T (Circle One) <br /> Transfer to <br /> Active/Inaclve <br /> Pro ram/Element and Description New OwneR <br /> 9Record ID Employee ID and Name Status Delete <br /> 2957-UST FILE-RWQCB PR0522692 EE0000684-MICHAEL INFURNA Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: L the undersigned owner,operator or agent of same,acknowledge that all site,and/or Project spec,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 /> Stale andror Federal Laws. <br /> APPLICANTS 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 Type Check Number Received by <br /> REHS: Date /_/ Account out: Date <br /> COMMENTS: <br /> \\phs-ehsq I-nt\apps\e nvisions\reports\5021.rpt <br />