Laserfiche WebLink
�./ <br /> Run by STAFF � ) I <br /> SaT'l�Joaquin County PHS/EHD Report 50 21 <br /> --------------------FACILITY-INFORMATION as of 04/08/98 <br /> -------------------=------ <br /> P <br /> ------------------------ <br /> i <br /> I OWNER FILE INFORMATION Make changes/corrections in RED pen or pencil: <br /> I INFORMATION CHANGE (date): --� <br /> OWNERSHIP CHANGE (date): {J <br /> OWNER ID: 006401 <br /> owner Name: STOCKTON AUTO CENTER New Owner'!ID: 0 <br /> Owner DBA: <br /> Owner Address: 3158 AUTO CENTER CIR E <br /> STOCKTON, CA 95212 � <br /> Home Phone: <br /> f <br /> soc sec# / Tax ID#: FED ID#6 8-0 0 713 7 II <br /> p Type: 01 CORPORATION <br /> Ownershi � <br /> I <br /> i <br /> i <br /> Mailing Address: 3158 AUTO CENTER CIR STE 3 <br /> Care of: <br /> STOCKTON, CA 95212 i <br /> FACILITY FILE INFORMATION <br /> FACILITY ID: 007741 <br /> Facility Name: AUTO ZONE INC <br /> Location: 1100 N WILSON WY <br /> STOCKTON 95202 <br /> Phone: <br /> i <br /> i <br /> Mailing Address: 1100 N WILSON WY <br /> Care of: AUTO ZONE INC <br /> h � <br /> STOCKTON, CA 95202 ! <br /> i <br /> Location Code: 0 1 APN: <br /> BOS District: SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> ACCOUNT ID: 0 013 626 New Account ID: 000 <br /> Mail Invoices to: Account Mail Invoices to: Owner / Facility / Account i <br /> Account Name: ANTHONY TAYLOR CONSULTANTS (Circle one) <br /> Account Balance as of 04/08/98 $0 . 00 <br /> (Circle=/oInactivate <br /> Record UST(s) Transfer to Activate , <br /> P/E Description ID Employee Status Linked new owner? Delete <br /> ----------------------------- <br /> -- ENVIRON ASSESS ----------PR--- - I--- ----- ACTIVE--- -----Y- N ----A -( I / D <br /> ------------- --------- ---- ��---------- <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I, the undersigned owner, operator or agent of same,' acknowledge that all site and/or <br /> .f <br /> project specific PHS/EHD hourly charges associated with this facility or activity will be billed to the party identified as the ti <br /> BILLING PARTY on this form. I also certify that all operations will be performed in+ accordance with all applicable SAN JOAQUIN <br /> i <br /> COUNTY Ordinance Codes and/or Standards and State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: II! Date <br /> --------------------------------------------------!I <br /> PR Records to be TRANSFERED: x $20.00 = Amount Paid '; Date <br /> Water System to be TRANSFERED: x $150.00 = Amount Paid ;i. Date <br /> Payment Type Check # j Recvd by <br /> REHS or COUNTER SUPV: <br /> Date / ACCT out: Date,! �j <br /> -�—j((��� ��/ O / UNIT/File: ---/---/ <br /> Run by : STAFF San Joaquin County PHS/EHD Report #5021 <br /> -------------------FACILITY INFORMATION as of 04/08/98 <br /> --------------------------- i <br /> ------------------------------- <br /> li , <br />