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Date run 7/9/2015 9:18:33AM SA*AQUIN COUNTY ENVIRONMENTALI) j DEPARTMENT Report#5021 <br /> Run by <br /> Facility Information as of 7/9/2015 Pagel <br /> Record Selection Criteria: Facility ID FA0001393 <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: 2 SSN/Fed Tax ID <br /> Owner ID OW0005792 New Owner ID <br /> Owner Name SANDHU, GURENDERJEET S <br /> Owner DBA <br /> OwnerAddress 1807 HENRY CT <br /> RIPON, CA 95366 <br /> Home Phone 209-599-8707 <br /> Work/Business Phone 209-239-4550 <br /> Mailing Address 1807 HENRY CT <br /> RIPON, CA 95366 <br /> Care of <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility lD/CERS ID FA0001393 10180741 <br /> Facility Name MANTECA LIQUOR & FOOD <br /> Location 890 N MAIN ST <br /> MANTECA, CA 95336 <br /> Phone 209-239-4550 x <br /> Mailing Address 890 N MAIN ST <br /> MANTECA, CA 95336 <br /> care of Gurenderjeet sandhu <br /> Location Code 04-MANTECA Alt Phone <br /> BOS District 003- BESTOLARIDES, STEVE Fax <br /> APN 22302007 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name SANDHU, GURENDERJEET S <br /> Title <br /> Day Phone 209-239-4550 <br /> Night Phone 209-538-8541 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0001392 NewAccount ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name MANTECA LIQUOR& FOOD (Circle One) <br /> Account Balance as of 7/9/2015: $0.00 <br /> (Circle One) <br /> Program/Element and Description Record to to Active/Inactve <br /> ID Employee ID and Name status New Owners Delete <br /> 1617-RETAIL MARKET>1000 SO FT W/FOOD PREP PRO161238 EE0004589-KADEANNE LINHARES Active Y N A I D <br /> 1920-HMBP-Common Materials PRO521196 EE0002474-MICHAEL PARISSI Active Y N A I D <br /> 2220-SM HW GEN<5 TONSNR PR0522590 EE0009001 -ELENA MANZO Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO513066 EEo000000-HAZ MAT SJC DES Inactive Y N A I D <br /> 2301-UST STATE SURCHARGE FEE PR0507683 EE0007289-ALISON YOUNGBLOOD Inactive Y N A I D <br /> 2361 -UST FACILITY PR0231984 EE0009001 -ELENA MANZO Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FI PRO507276 EE0007289-ALISON YOUNGBLOOD Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGI PRO531504 Inactive Y N A I D <br />