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Daterun. 3142/2018 2:30:34PR SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 3/22/2018 <br /> Record Selection Criteria: Facility ID FA0023022 <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 OW0021059 New Owner ID <br /> Owner Name Alfred Wright <br /> Owner DBA J & E TRUCK SERVICE & REPAIR INC <br /> Owner Address 8426 ROXBURGH WAY <br /> STOCKTON, CA 95209 <br /> Home Phone 209-465-3162 <br /> Work/Business Phone 209-465-3162 <br /> Mailing Address PO BOX <br /> ,7,647 <br /> Stc on, CA 95267 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility lD/CERS ID FA0023022 10628797 <br /> Facility Name J & E Truck Service and Repair, In . <br /> Location 1483 W Anderson St <br /> Stockton, CA 95206 <br /> Phone 209-465-3162 x p <br /> Mailing Address PO BO 47 4 O 3 W 50 r) St" <br /> St on, CA 95267 5h1l.ICt�r1 5�L <br /> Careo Ifred Wright Jr. <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District Fax <br /> APN EMail <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone 209-465-3162 <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0042237 NewAccount ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name Danielle Wright (circle one) <br /> Account Balance as of 3/22/2018: $0.00 <br /> (Circle One) <br /> Transfer to Active/Ina ive <br /> Program/Element and Description Record 10 Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PR0540790 EE0009817-ROBERT LOPEZ Active Y N A I D <br /> 2227-GEN 13<25 TONS PERMIT PR0540380 EE0000026-CESAR RUVALCABA Active Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PR0540273 EE0009000-HARPRIT MATTU Inactiv[ Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andor 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 call that all operations will be performed in accordance with all applicable Ordinance Codes andor Standards and State andor <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 / 1 Account out: Date / / <br /> COMMENTS: <br /> Invoice#: <br /> /" VLli1.t.C. <br /> Fla phi <br /> � b�w� <br />