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FDate run 1/10/2013 9:56:32AR SAN JO IN COUNTY ENVIRONMENTAL HEAT !DEPARTMENT Report aw21 <br /> Run by \410, Pagel <br /> Facility Information as of 1/10/2013 <br /> Record Selection Criteria: Facility ID FA0018692 <br /> Make changeslcorrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN/Fed Tax ID <br /> Owner ID OW0015359 New Owner ID <br /> Owner Name SHERWIN WILLIAMS <br /> Owner DBA <br /> Owner Address 101 PROSPECT AVE NW <br /> CLEVELAND, OH 441151075 <br /> Home Phone 216-566-2000 <br /> Work/Business Phone Not Specified <br /> Mailing Address 101 PROSPECT AVE NW <br /> CLEVELAND, OH 441151075 <br /> Care of SOLTES, MIKE <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0018692 <br /> Facility Name SHERWIN WILLIAMS AUTO FINISH 49828 <br /> Location 3734 IMPERIAL WAY UNIT D <br /> STOCKTON, CA 95215 <br /> Phone 209-466-2652 _ <br /> Mailing Address 101 PROSPECT AVE NW <br /> CLEVELAND, OH 441151075 <br /> Care of SOLTES, MIKE <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOS District 002- RUHSTALLER, LARRY Fax <br /> APN 17925033 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 AR0033138 Now Account ID: <br /> Maillnvoicesto Facility Mail invoices to: Owner / Facility / Account <br /> Account Name SHERWIN WILLIAMS AUTO FINISH#9828 (Circle One) <br /> Account Balance as of 1/10/2013: $0.00 <br /> (Circle One) <br /> Transfer to ActivaInactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PRO528022 EE0009817-ROBERT LOPEZ Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR0527586 EE0001421 -STACY RIVERA Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHPR0533767 Inactive 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 1 also cedity that all operations will be Performed in accordance with all applicable Ordinance Codes ai Standards and State ands <br /> Federal Laws. <br /> APPLICANTS SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date I ! <br /> Payment Type Check Number Received by <br /> REHS: Date /_/_ Account out: Date <br /> COMMENTS: <br />