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In P Administrative Module <br /> Office Of <br /> Emergency Services <br /> Hazardous <br /> Program <br /> Business Site InformationAnnual Certification and Inspections <br /> Business ID No. ;10677 Date Acct Created 6/24/02 Ann'I Cert Sent 12/2/02 Due' 1/L 16/O3 <br /> Web Password tr75431 Annual Cert Recd Date <br /> Business Name I TRACY AUT REPAIR Web Certification Received <br /> Site Address599 �LE 11 H <br /> Correct Action Due Date <br /> Street Type IST Suite/Appt/Bldg � <br /> Reg Ten Day LtrDue _ <br /> City TRACY State CA <br /> DA 10 Day Ltr �_Due L <br /> Zip Code 95376 Phone 1209-914-6974 <br /> Nature AUTO REPAI SHOP Assigned Inspector IPARISSI FD Co.L_ <br /> Primary Contact RAHMON SO O Last Insp Date By <br /> Insp Follow Up Date By <br /> E-Mail <br /> Initial HMMP/Data Entry Controls <br /> Status and Billing CodesHMMP Packet <br /> Filingsent 11/22/02 <br /> Type Y Y �"l)��NO2� <br /> T yp �❑ H MP Status INEW HMMP Due Date 12/23/02 Rec'd I NO <br /> Reg Sub On-Site MP Status <br /> I Data Entry Needed Date� <br /> Fire District 19 Annual MMP Fee Map Scan Needed Compl <br /> Trade Secrets �_ Spe ial Status <br /> Disk/E-Mail/Web Tempi Ver <br /> Billable Chems �_ Primary/ econdary <br /> IWaste Gen Fe Category IPENDING Person Completing <br /> HMMP Year 2003 Am nded Bill I Quality Assured By Date <br /> Chems on File Back Bill I Annual Fee Billed By <br /> SPCC Onsite Enforce Category Amended Bill Sent By <br /> Mailing Address (If other tha� Business Site Address) <br /> Address I I I I I <br /> City State Zip Code <br /> Facility Map Names <br /> Primary Map Sub Map # Sub Map#2 Sub Map #3 Sub Map#4 Sub Map#5 <br /> I I <br /> HMMP Fee Review Verification and Special Billing Instructions <br /> Review Sign Of Amended/Back Bill Instructions Special Notes <br /> Fee Review Needed Chem Count �_ Fee Category <br /> I� Changed From Changed From <br /> Fr'o�oi'L- <br /> Reviewed By I� Date Back Bill '` `" "' Billed Years L 1 <br /> To I _ <br /> Date Created 6/24/2002 Da Modified 12/2/2002 Last Modified By: Ron Baldwin <br /> aa� �� 0 910-7 <br />