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.n. A dtmffkrative Mod " <br /> Office 1 <br /> Emergency Services <br /> Hazardous <br /> Management Program <br /> Business Site Information Annual Certification and Inspections <br /> Business ID No. 12929 Date Acct Created 2/28/06 Ann'I Cert Sent Due <br /> Web Password IRXZ18785 RMP Surcharge I — Annual Cert Rec'd Date_ WebLL <br /> Business Name lR&R MCCULLOUGH MOBILE REPAIR <br /> RCA Due DateL_ Email Sent <br /> Site Address 1177 1 IKEL.LY Reg Ten Day <br /> Uri Due <br /> Street Type I ST Suite/Appt/Bldg <br /> City LODI Slate CA DA 10 Day Ltr �Due <br /> Scheduled for Inspection R <br /> Zip Code L5240-3107 Phone 1209-334-4305 _ <br /> Nature IREPAIRING OF TRUCKS Assigned Inspector DELAROSA FDCo.� <br /> Lastlnsp Date �_ By <br /> Primary Contact IRANDY MCCULLOUGH <br /> Insp Follow Up Date, By <br /> E-Mail I ronda_mcc@ sbcglobal.net <br /> Initial HMMP/Data Entry Controls <br /> Status and Billing Codes HMMP Effect Date 2/2$/06 III 228/06 <br /> � <br /> Filing Type QY HMMP Status NEW Uatc <br /> Reg Sub On-Site NO RMP Status -. HMMP Due Date 3/30/06 Recd NO <br /> Fire District 120 Annual HMMP Fee $0.00 Data Entry Needed ND Compl 3/30/06 <br /> Trade Secrets I NO Current HMMP Feel Map Scan Needed Web Use I YES <br /> Billable Chems I Enforce Category I Person Completingl K LAWRENCE <br /> Waste Gen I YES Special Status I <br /> Quality Assured ByL_ Date <br /> HMMP Year 12006 Primary/Secondary <br /> Chems on File I Fee Category PENDING n'I Fee Ref Datel <br /> Amend Bill Ret Date <br /> SPCC Onsite IYES Amended Bil _Amt__ I <br /> Amended Bill Sent <br /> Amend Describe 1 Old S stem By <br /> Mailing Address (If other than Business Site Address) <br /> Address 177 ISIKELLY ST <br /> City [LODI State CA ZipCodi <br /> fFacility Map Names <br /> I Primary Map Sub Map #1 I Sub Map#2 I Sub Map #3 I Sub Map #4 I Sub Map#5 <br /> HMMP Fee Review Verification and Special Billing Instructions <br /> Review Sign Of Amended/Back Bill Instructions Special Notes <br /> Fu: kccic„ A'ccdcd Chem Count Fee Category 1 <br /> IChanged From Changed From I <br /> �_ f , <br /> Reviewed By �_ Date Back Bill ,From Billed Years <br /> To I� for Backbilling <br /> ate Created 2/28/2006 Date Modified 4/21/2006 Last Modified By: Kathy Lawrence <br />