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DAte run 2/25/2021 3:34:28PK SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 2/25/2021 <br /> Record Selection Criteria: Facility ID FA0002382 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 1 SSN/Fed Tax ID <br /> Owner ID OW0024532 New Owner ID <br /> Owner Name BHATOY, LALIT <br /> Owner DBA STAY INN SUITE <br /> Owner Address PO BOX <br /> RO IN, CA 95677 — <br /> Work/Business Phone Not Specified 7 <br /> Alternative Phone 415-926-2555 <br /> Mailing Address PO BOX 5 <br /> ROVLIN, CA 95677 <br /> Care of BHATOY, LALIT <br /> FACILITY FILE INFORMATION APN 13719028 <br /> Facility ID/CERS ID FA0002382 <br /> Facility Name STAY INN SUITE <br /> Location 631 N CENTER ST <br /> STOCKTON, CA 95202 <br /> Phone 415-926-2555 <br /> Mailing Address PO BO 65 <br /> ROPKLIN, CA 95677 <br /> Care of BHATOY, LALIT <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name BHATOY, LALIT <br /> Title <br /> Day Phone 415-926-2555 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0004608 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name STAY INN SUITE (Circle One) <br /> Email invoice to(up to 2 emails) <br /> Email permit to(up to 2 emails) <br /> Account Balance as of 2/25/2021: $304.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2417-HOTEL/MOTEL 26-50 PR0240084 EE0002089-OMRAN SOOD Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific.PHS/EHD hourly charges associated with this facility <br /> or activity will be billed to the party identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinance Codes andror Standards and State and/or <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: *$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type Check Number Received by <br /> EHD Staff: Date / / Account out: Date <br /> COMMENTS: <br /> Ir1VOICe#: <br />