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Date run 3/31/2016 12:44:09PI SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 3/31/2016 <br /> Record Selection Criteria: Facility ID FA0009208 ' <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 OW0007208 Case Number: H02050 New Owner ID <br /> Owner Name WESTERN PIPING PRODUCTS <br /> Owner DBA WESTERN PIPING PRODUCTS <br /> Owner Address PO BOX 6391 S <br /> BAKERSFIELD, CA 933020639 <br /> Home Phone Not Specified <br /> Work/Business Phone 661-589-9141 <br /> Mailing Address PO BOX 639 <br /> BAKERSFIELD, CA 933020639 PD (3aX 3`I <br /> Care of 1301 tZ"5 4;z(J,('—/-k 1 33o� <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0009208 <br /> Facility Name WESTERN PIPING PRODUCTS P . }" ('>n <br /> Location 2245 W CHARTER WAY I ), Li IS <br /> STOCKTON, CA 95206 LLCM; <br /> Phone 209-337-0055 x0 2bel - 31 7- Ob <br /> Mailing Address PO BOX 639 t 0 I (I .3c <br /> BAKERSFIELD, CA 933020639 t'nJ16,,,;�"e &A 13 10'z <br /> Care of T— <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOS District 001 -VILLAPUDUA, CARLOS Fax Oq_ 3)i -0060 <br /> APN 16336017 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016208 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name WESTERN PIPING PRODUCTS (Circle One) <br /> Account Balance as of 3/31/2016: $0.00 4P <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PR0519461 EE0009817-ROBERT LOPEZ Inactive Y N AD 1 D <br /> 2220-SM HW GEN<5 TONS/YR PR0513700 EE0002646-THUY TRAN InactivE Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511496 EE0000000-HAZ MAT SJC OES InactivE Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FI PR0509208 EE0000000-HAZ MAT SJC OES InactivE 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 Slate and/or <br /> Federal Laws. ?` <br /> APPLICANT'S SIGNATURE: Date 3 / J/ l 20[4/ <br /> Program Records to be TRANSFERED: "$25.00= Amount Paid Date / / <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type 12 Check Number Received by <br /> EHD Staff: 2 Date J ;ount out: t+5— Date YEJ: <br /> COMMENTS: Invoice#: 2--7 <br />