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Doemin 5/21/2015 3:06:36PM1Report#5021 <br /> SAN JO IN COUNTY ENVIRONMENTAL HEA. DEPARTMENT <br /> Run by Paget <br /> Facility Information as of 5/2112015 <br /> Record Selection Ulan& Facility ID FA0006423 <br /> Make changes/corrections In RED ink. <br /> INFORMATION CHANGE(date) <br /> <br /> <br /> : <br /> Owner Name ,Tulip-Gahan �Anr.�n m�C�h <br /> Owner DSA q <br /> Owner Address � tK A/ <br /> Home-Phane-40&=Q-3>#�f� <br /> none--"408-2346ze_0 <br /> Baa� war✓,t�-� �. <br /> JUUQ --- <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility ID/CERS ID FA0006423 10182099 <br /> FacilityName UNITEDOAS' <br /> Location 3440 E MAIN ST <br /> STOCKTON, CA 95206 <br /> IV ailing Add es�� t/,/AN <br /> I nn Oen - � le gN'�n( <br /> Location Code 01 -STOCKTON Alt Phone, <br /> BOSDistrict 001 -VILLAPUDUA, CARLOS Fax <br /> APIN Email: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact NameN0 Ma1nPrPQ� �t�h <br /> Title PAYMENT <br /> pay 46 RECEIVED <br /> OS <br /> ACCOUNTS RECEIVABLE FILE INFORMATION MAY 2 6 2015 <br /> Account Io Account 05 SAN JOAQUIN COUNTY New <br /> Mail Invoices to Account ENVIHOMENTAL Mail InvOioesto: 151rcle <br /> Facility Account <br /> Account Name UNIT G <br /> HEALTH DEPARTMENT One) <br /> Account Balance as of 5121!201 $,0.00 <br /> (Clrcla One) <br /> Transrerto Aotive/Inacbe <br /> ProgramtElement and Description Record to Employee ID and Nam Status NewOvmer? Delete <br /> �1 RETAIL MKT 301-2000 SO FT((PRE��PKKGD54TD PF PRO161544 EE0008999-LEYNA HUYNH Active Y N A I D <br /> MBP-Common Materials ( / Cllr/ PR0521208 EE0000006-HAZA SAEED Active Y N A I D <br /> M HW GEN<5 TONSIYR PROB18582 EE0000021-CINDY VO Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO612638 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 23 UST STATE SURCHARGE FEE PR0507753 EE0000008-LETITIA BRIGGS Inactive Y N A I D <br /> 361UD <br /> ST FACILITY PRO231173 EE0000027-CINDY VO Active Y N A 1 <br /> - <br /> UNIFIED PROGRAM FAC STATE SURCHARGE F PROB07625 EE0000008-LETITIA BRIGGS Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PR0518584 EE0001422-AR18VELOSO Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO533195 Inactive Y N A I D <br />