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Date.run 12/7/2021 12:19:51 PI SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br />Run by Pagel <br />Facility Information as of 12/7/2021 <br />Record Selection Criteria: Facility ID FA0003147 <br />OWNER FILE INFORMATION Number of facilities for this owner <br />Owner ID <br />OW0002348 <br />Owner Name <br />TONY R SILVA INC <br />Owner DBA <br />TONY R SILVA INC <br />OwnerAddress <br />5152 W GRANT LINE RD <br />TRACY, CA 95304 <br />Work/Business Phone <br />209-835-3895 <br />Alternative Phone <br />Not Specified <br />Mailing Address <br />5152 W GRANT LINE RD <br />TRACY, CA 95304 <br />Care of <br />FACILITY FILE INFORMATION APN 25009001 <br />Facility ID / CERS ID FA0003147 <br />Facility Name TONY R SILVA INC <br />Location 5152 W GRANT LINE RD <br />TRACY, CA 95304 <br />Phone 209-835-3895 <br />Mailing Address 5152 WGRANTLINE RD <br />TRACY, CA 95304 <br />Care of SILVA, ROBERT <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name SILVA, ROBERT <br />Title <br />Day Phone 209-835-3895 <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0002713 <br />Mail Invoices to Facility <br />Account Name TONY R SILVA INC <br />Email invoice to (up to 2 emails) tonyrsilvainc@comcast.net <br />Email permit to (up to 2 emails) tonyrsilvainc@comcast.net <br />Account Balance as of 12/7/2021: $305.00 <br />Make changes/corrections in RED ink. <br />INFORMATION CHANGE (date) <br />OWNERSHIP CHANGE (date) <br />SSN / Fed Tax ID <br />New Owner ID : <br />Mail Invoices to: <br />New Account ID: : <br />Owner / Facility <br />(Circle One) <br />Account <br />(Circle One) <br />Transfer to Active/Inactve <br />Program/Element and Description Record ID Employee ID and Name Status New Owner? De ele <br />4244 - PUMPER TRUCK PR0420036 EE0009852 -ALDARA SALINAS Active Y N A I D <br />4246 - PUMPER YARD PR0420057 EE0009852 -ALDARA SALINAS 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 and/or Standards and State andlor <br />Federal Laws. ' / <br />APPLICANT'S SIGNATURE: ei'�� G1 �� Date/ /�!/ <br />.01 <br />Program Records to be TRANSFERED: ' $25.00 = Amount Paid Date <br />Water System to be TRANSFERED: Amount Paid Date <br />Payment Type C [nb, Received <br />EHD Staff: Date ��1-j —/-2 y ccount out: Date <br />COMMENTS: // <br />Invoice #: <br />