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We run 12/15/2011 8:58:13A SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 12/15/2011 <br /> F Record Selection Criteria: Facility ID FA0000229 <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 OW0000182 New Owner ID <br /> Owner Name SWEET SEPTIC SYSTEMS, INC <br /> Owner DBA SWEET SEPTIC SYSTEM INC <br /> Owner Address 5701 MOTHER LODE DR <br /> PLACERVILLE, CA 95667 <br /> Home Phone Not Specified <br /> Work/Business Phone 530-622-8768 <br /> Mailing Address 5701 MOTHER LODE DR <br /> PLACERVILLE, CA 95667 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000229 <br /> Facility Name SWEET SEPTIC SYSTEMS INC <br /> Location 25443 N HWY 99 <br /> ACAMPO, CA 95220 <br /> Phone 209-368-5105 x0 <br /> Mailing Address 5701 MOTHER LODE DR <br /> PLACERVILLE, CA 95667 <br /> Care of <br /> Location Code 99- UNINCORPORATED P Alt Phone <br /> SOS District 004 -VOGEL, KEN Fax <br /> APN 00514303 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 AR0000228 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name SWEET SEPTIC SYSTEMS, INC (Circle One) <br /> Account Balance as of 12/15/2011: $268.00 <br /> (Circle One) <br /> Program/Element antl Description Record ID to Active/Inactve ID Employee ID and Name Status New Owner? Delete <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPR0512836 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-OES PRO520414 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARIPRO510548 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATNPR05-15711 EE0001422-ARIS CACAPIT Active,Exempt Y N A I D <br /> 4244-PUMPER TRUCK PR0420010 EE0000644-TED NORGARD Inactive Y N A I D <br /> 4244-PUMPER TRUCK PR0420101 EE0005366-LISA MEDINA Inactive Y N A I D <br /> 4244-PUMPER TRUCK PR0506067 EE0000644-TED NORGARD Inactive Y N A I D <br /> 4244-PUMPER TRUCK PR0515374 EE0005366-LISA MEDINA Inactive Y N A D <br /> 4244-'PUMPER TRUCK. - ,PR0531107 :EE0005366-LISA MEDINA --Active - Y N A I D <br /> 4246-PUMPER YARD PR0420044 EE0005366-LISAMEDINA Active Y N A 1 D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHPRO533079 Active Y N A I D <br /> \\eh-en Aenvision\reports\5021.rpt <br />