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OWNER FILE INFORMATION J Make changes/corrections in RED pen or pencil: <br /> �i INF r ION CHANGE (date) : <br /> OWN�P CHANGE (date) : <br /> OWNER rD: 006374 11 <br /> Owner Name: THRIFTY OIL COMPANY New owner ID: 00 <br /> r <br /> _,- <br /> Owner DBA: THRIFTY OIL #171 . <br /> I owner Address: 13-539 E FOSTER r <br /> SANTE FE SPRINGS, CA 90670 } <br /> Home Phone: 562-921-3581 r <br /> Soc Sec# / Tax ID#: r� i <br /> Ownership Type: 01 CORPORATION <br /> q Mailing Address: 13539 E FOSTER <br /> care ot: CHRIS PANIATESCU <br /># SANTE FE SPRINGS, CA 90670 <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 007 717 <br />{ i <br /> Facility Name: THRIFTY OIL #171 <br /> Location: 1250 N WILSON WAY <br /> STOCKTON SPRINGS 95205 <br /> Phone: <br /> l Mailing Address: 13539 E FOSTER !� <br /> i <br /> care of: CHRIS PANIATESCU <br /> SANTE FE SPRINGS, CA 90670 <br /> Location Code: APN: <br /> 11 BOS District: SIC Code: <br /> % <br /> ACCOUNTS RECEIVABLE FILE INFORMATION I III <br /> r <br /> ACCOUNT ID: 0013348 New Account ID: ( 000 <br /> Mail Invoices to: Facility Mail Invoices to:: Owner / Facility / Accou It <br /> Account Name: THRIFTY OIL #171 �� (Circle one) <br /> �. Account Balance as of 0 4/0 8/9 8 : $0 . 00 II (Circle <br /> Record UST(s) • Transfer to Activat / Inactivat <br /> P/E Description ID Employee Status Linked new owner? Dele <br /> ----------------------------------------------- i ----------------- <br /> ------------------ --------- <br /> ------- <br /> 2950 ENVIRON ASSESS PR507153 0664 INFURNA ACTIVE �i Y N A D I <br /> -------------------------------------------------1----------------------------- <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same, acknowledge that all site and/or <br /> project specific PHS/EBD hourly charges associated with this facility or activity will be billed to the party identified as the <br /> BILLING PARTY on this form. I also certify that all operations will be performed in accordance with all applicable SAN JOAQUIN <br /> COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. i <br /> APPLICANT'S SIGNATURE: h Date <br /> - <br /> PR Records to be TRANSFERED: x $20.00 = Amount Paid �,i ip Date / / <br /> Water System to be TRANSFERED: x $150.00 = Amount Paid Date <br /> ---------------- -------Payment 'Type ----....----- Check #-!� ---...------Recvd by=.-==__--______ <br /> ' REHS or COUNTER SUPV, - Date / '` ACCT out: �•_v- Date -/ 4 /C UNIT/File: <br /> Runby : STAFF San Joaquin County PHS/EHD Report #5021 <br /> .FACILITY INFORMATION as of 04/08/98 <br /> _ � - ---- ------------- - ---- 'i ------- ---------------- <br />