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Date run -IIN COUNTY ENVIRONMENTAL HEALT" DEPARTMENT Report#5021 <br /> 7f7/2008 9:32:33AM <br /> SANJOt <br /> Pagel <br /> Run h'' tie, Facility Information as of 7/7/200&/' <br /> Record Selection Criteria: Facility ID FA0014270 ian Joa uln ounty DIRECTOR <br /> Pp U,IN Environmental Health De�,��q elF bonsin lR�EEpp t�r�l1�kr� nDo�dt <br /> tuaaq'�'r� A551STARI708IRECTOR <br /> ,G INFORMATION CHANCe��I&u,-a,-Rr,IS <br /> 2: .Z 600 East Main Street <br /> WNERSHIP CHANGE(date) <br /> Stockton, California 95202-3029OPROGRAM COORDINATORS <br /> OWNE �1 _ .'j N SSN/Fed Tax ID Ge I Bei,_let_ RE 16 <br /> OW0011324 New Owner ID : Mike A99;;:c,RFMS,RDI <br /> ese: www.s ov.or /ehd <br /> qt�1 me STOCKTON HONDPbit <br /> N/ 19 9 Margaret La orio, RENS <br /> Far DBA STOCKTON HONDA Phone: (209)468-34 Robert McClellon,REHS <br /> Owner Address 2002 E HAMMER LN Fax: (209) 464-0138 a Carruesco,REHS,RDI <br /> STOCKTON, CA 95210 asey oey, <br /> Home Phone Not Specified <br /> Work/Business Phone 209-289-3591 <br /> Mailing Address 2002 E HAMMER LN <br /> STOCKTON, CA 95210 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0014270 <br /> Facility Name STOCKTON HONDA <br /> Location 2002 E HAMMER LN <br /> STOCKTON, CA 95210 <br /> Phone 209-320-6700 x0 <br /> Mailing Address 2002 E HAMMER LN <br /> STOCKTON, CA 95210 <br /> Care of <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOS District 002 - RUHSTALLER, LARRY Fax <br /> APN 09406002 Entail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0024225 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name STOCKTON HONDA (CirdeOne) <br /> Account Balance as of 7/7/2008: $0.00 <br /> (Circle One) <br /> Transfer to Aaivannaclve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner' Delete <br /> 2244-PACT TRANSFER RECORD-DES PRO521015 EE0000000-HAZ MAT SJC DES Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARPR0519170 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO522830 EE5555555-Garrett Alias-Backus 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 spedBc.PHSIEHD hourly charges associated With this <br /> fadaty or activity wird W fir ed to the pant identified same OWNER on this form. I also certify that all operations will be performed in accordance with all applicaEle Ord'nrace Codes and/or Standards and <br /> Stale anon Federal Laws. <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: '$372.00= Amount Paid Date <br /> Payment Type Check Number Received by <br /> REHS: Dale / / Account out: Date / / <br /> COMMENTS: <br /> \lphs�hsgl-nt\apps\envisions\reports\5021.rpt <br />