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[Record <br /> run 12/30/2009 12:00:14( SAN JOi -'UIN COUNTY ENVIRONMENTAL HEAL` i DEPARTMENT <br /> by Report#5021 <br /> Facility Information as of 12/30/20 Pagel <br /> Selection Criteria: Facility ID FA0000903 <br /> Make changeslcorrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNER FILE INFORMATION OWNERSHIP CHANGE(date) <br /> SSN/Fed Tax ID <br /> Owner ID OW0000712 New Owner ID <br /> Owner Name EAVENSON, WM & BEV ETAL <br /> Owner DBA " <br /> Owner Address 17881 GLENWOOD DR <br /> MANTECA, CA 95336 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-823-4930 <br /> Mailing Address' 17881 GLENWOOD DR <br /> MANTECA, CA 95336 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000903 <br /> Facility Name STOCKTON 1 LODI RV PARK <br /> Location 2851 E EIGHT MILE RD <br /> LODI, CA 95240 <br /> Phone 209-941-2573 <br /> Mailing Address 17881 GLENWOOD DR .• <br /> MANTECA, CA 95336 <br /> Care Of EAVENSON, WILLIAM & BEVERLY <br /> Location Code 99 - UNINCORPORATED P Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> APN 05919006 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 AR0000900 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner 1 Facility I Account <br /> Account Name STOCKTON 1 LODI RV PARK (Circle one) <br /> Account Balance as of 1213012009: $236.00 <br /> (Circle One) <br /> Transfer to Activellnactve <br /> ProgramlElement and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1615-RETAIL MKT<2000 SQ FT (PREPKGD I LTDPR0160286 EE0003361 -MARIBEL FLOHRSCHU-Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORI7-ATIOIPRO511869 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-OES PRO519743 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2381 -UST FACILITY(BEFORE 1184)-obsolete PR0231558 EE0000451 -STEVE SASSON Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARiPR0509581 EI"0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 3611 -PUBLIC POOL/SPA-PRIMARY PR0360057 EE0003361 -MARIBEL FLOHRSCHUTActive Y N A I D <br /> 4242-WASTE WATER TX PLANT PR0420074 EE0005944-MICHAEL ESCOTTO Active Y N A (D D <br /> 4621 -15-24 SERVICE CONNECTIONS(CWS) WA0460947 EE0005838-ADRIENNE ELLSAESSEActive Y N A I D <br /> r <br /> ;< <br /> Ile h-e n vle n vi s i o nl re p o rts15021.rp t <br />