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Dale run 9/12/2013 10:55:06AI SANJUIN COUNTY ENVIRONMENTAL HE DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 9/12/2013 <br /> Record Selection Criteria: Facility ID FA0009349 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) Z ?0 <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSNI Fed Tax ID <br /> Owner ID OW0007349 Case Number: H03243 New Owner ID <br /> Owner Name FRED J MINER JR <br /> Owner DBA DIESEL PERFORMANCE INC <br /> Owner Address 2804 E FREMONT ST <br /> STOCKTON, CA 95205 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-946-0233 <br /> Mailing Address PO BOX 8387 <br /> STOCKTON, CA 95208 <br /> Care of <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility ID/CERS ID FA0009349 10,182,613 <br /> Facility Name DIESEL PERFORMANCE INC <br /> Location 2804 E FREMONT ST <br /> STOCKTON, CA 95205 <br /> Phone 209-946-0233 <br /> Mailing Address PO BOX 8387 <br /> STOCKTON, CA 95208 <br /> Care of <br /> Location Code 99- UNINCORPORATED P Alt Phone - - !3 <br /> BOS District 001 -VILLAPUDUA Fax 0 — 3 <br /> APN 14343001 EMaiI: -lqrm I rQ r S n /p7(— <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone QqA —Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016349 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name DIESEL PERFORMANCE INC (Circle One) <br /> Account Balance as of 9/12/2013: $0.00 <br /> (Circle One) <br /> Transfer to ActivaimacNe <br /> Progrann Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PR0519569 EE0006044-LOWELL ALLEN Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511637 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2227-GEN 5<25 TONS PERMIT PRO513781 EE0009488-JEFFREY WONG Active Y N A I D <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0601364 EE0000008-LETITIA BRIGGS Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PR0509349 EEOOOOOOO-HAZ MAT SJC DES Inactive Y N A I D <br /> 2840-AST EXEMPT FAC < 1,320 GAL PRO528343 EE0009488-JEFFREY WONG Active,l Y N A I D <br /> 3122-STORMWATER INSPECTION-AUTO SHOP PR0529448 EE0009488-JEFFREY WONG Inactive Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO524079 EE0002622-BENJAMIN ESCOTTO Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO534595 Inactive Y N A 1 D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andor proiect speck,PHSIEHD hourly charges associated with this facility <br /> or activityvAl be billed to the pfurty Identified as the OWNER on this form Ialso certify that all operations will be performed in accordance with all applicable Ordinance Codes amllor Standards and State andor <br /> .deral La <br /> APPLICANT'SO <br /> SIGNATURE: l i • l / 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 y <br /> REHS: Date / / Account out: Date�d I y l l3 <br /> COMMENTS: <br />