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Date nm 10/31/2014 1:20:01PJ Report#5021 <br /> SAN JO�IIN COUNTY ENVIRONMENTAL HEA; Pagel <br /> Run by Facility Information as of 10/31/200111eDEPARTMENT 4 <br /> Record Selection Criteria: Facility ID FA0021137 <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 OW0017412 New Owner ID <br /> Owner Name TTL Automotive Enterprises, Inc. <br /> Owner DBA <br /> Owner Address 301 W KETTLEMAN LN <br /> LODI, CA 95240 <br /> Home Phone 530-400-2613 <br /> Work/Business Phone 530-400-2613 <br /> Mailing Address 1113 Los Robles Street <br /> Davis, CA 95618 <br /> Care of LYON, THOMAS S <br /> FACILITY FILE INFORMATION <br /> Facility lD/CERS ID FA0021137 10187759 <br /> Facility Name OILSTOP <br /> Location 301 W KETTLEMAN LN <br /> LODI, CA 95240 <br /> Phone 209-368-9779 x <br /> Mailing Address 1113 Los Robles Street <br /> Davis, CA 95618 <br /> Care of LYON, THOMAS S <br /> Location Code Alt Phone <br /> BOS District 004 -VOGEL, KEN Fax <br /> APN 04514002 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 AR0038120 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name OILSTOP (Circle One) <br /> Account Balance as of 10/31/2014: $0.00 <br /> (Circle One) <br /> Transfer to Acgvennactve <br /> Program/Element and Description Record 10 Employee ID and Name status New Owner? Delete <br /> 1920-HMBP-Common Materials PR0536822 EE0008709-JAMIE DE LA ROSA Active Y N A I D <br /> 2228-GEN 25<50 TONS PERMIT PRO536804 EE0001422-ARTS VELOSO Active Y N A I D <br /> 2332-EXEMPT TANK FACILITY PR0535303 EE0001422-AIRS VELOSO Inactive Y N A I D <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0538222 EE0001422-ARTS VELOSO Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0536805 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT'. I,the undersigned owner,operator or agent of same,adnowledge that all site,andor project specific,PHSfEHD hourly charges associated with this facility <br /> or activity will be billedto 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 ander 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 Paitl Date <br /> Payment Type Check Number Received by <br /> REHS: Date / / Account out: Date <br /> COMMENTS: <br />