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Date run 12/26/2012 8:26:32A SAN J( UIN COUNTY ENVIRONMENTAL HEA I DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 12/26/2012 <br /> Record Selection Criteria: Facility ID FA0004345 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0005112 New Owner ID <br /> Owner Name SINGH, BACHITAR <br /> Owner DBA JAHANT FOOD N FUEL STOP <br /> Owner Address 24323 N HWY 99 <br /> ACAMPO, CA 95220 <br /> Home Phone 209-333-6000 <br /> Work/Business Phone 209-339-1874 <br /> Mailing Address PO BOX 2735 <br /> LODI, CA 95241 <br /> Care of SINGH, BACHITAR <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility ID FA0004345 <br /> Facility Name JAHANT FOOD & FUEL <br /> Location 24323 N HWY 99 <br /> ACAMPO, CA 95220 <br /> Phone 209-333-2972 <br /> Mailing Address PO BOX 2735 <br /> LODI, CA 95241 <br /> Care of <br /> Location Code 99- UNINCORPORATED A Alt Phone <br /> BOS District 004-VOGEL, KEN Fax <br /> APN 00516019 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0007862 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name SINGH, BACHITAR (Circle One) <br /> Account Balance as of 12/26/2012: $-187.50 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> ProgranVElement and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1616-RETAIL MARKET<1000 SQ FT W/FOOD PIPRO500104 EE0001084-STEPHANIE RAMIREZ Active Y N A I D <br /> 1921 -HMBP-Reqular-Primary Location PR0520273 EE0008709-JAMIE DE LA ROSA Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR0518101 EE0001422-ARIS CACAPIT Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512651 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2301 -UST STATE SURCHARGE FEE PR0507746 EE0004636-GARRETT BACKUS Inactive Y N A I D <br /> 2361 -UST FACILITY PR0231947 EE0001422-ARIS CACAPIT Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHAR(PR0507173 EE0004636-GARRETT BACKUS Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCRPR0534137 Inactive Y N A I D <br /> 4633-TNC WATER SYSTEM WA0461108 EE0005838-ADRIENNE ELLSAESSEActive Y N A I D <br />