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Date run 11/6/2014 10:14:20AI SAN JO*JIN COUNTY ENVIRONMENTAL HEA19 DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 11/6/2014 <br /> Record Selection Criteria: Facility ID FA0007076 <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 OW0012706 New Owner ID <br /> Owner Name REGAL CINEMAS INC <br /> Owner DBA <br /> Owner Address 7132 REGAL LN <br /> KNOXVILLE, TN 37918 <br /> Home Phone 865-922-1123 <br /> Work/Business Phone 865-925-9494 <br /> Mailing Address 7132 REGAL LN <br /> KNOXVILLE, TN 37918 <br /> Care of REGAL CINEMAS INC <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0007076 10182179 <br /> Facility Name STOCKTON HOLIDAY CINEMAS#8 <br /> Location 6262 WEST LN <br /> STOCKTON, CA 95210 <br /> Phone 209-955-5683 <br /> Mailing Address 7132 REGAL LN <br /> KNOXVILLE, TN 37918 <br /> Care of CLIFF CHADWELL <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 002 - RUHSTALLER, LARRY Fax <br /> APN 09434001 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name CLIFF CHADWELL <br /> Title <br /> Day Phone 209-955-5683 <br /> Night Phone 865-925-9494 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0010235 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name REGAL CINEMAS INC (Circle One) <br /> Account Balance as of 11/6/2014: $0.00 <br /> (Circle One) <br /> Transfer la Acdve/Inactva <br /> PrograMElement and DesorptionRecoil ID Employee 10 and Name status New Owner? Delete <br /> 1612-FOOD EST<500 SQ FT W/O SEATING PR0505909 EE0001084-STEPHANIE RAMIREZ Active Y N A I D <br /> 1921 -HMBP-Regular-Primary Location PR0520834 EE0000006-HAZA SAEED Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO515851 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PRO515852 EE0000149-RAYMOND BORGES Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO532843 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and'or 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. I also certify that all operations will be performed in accordance with all applicable Ordinance Codes andior Standards and State andhor <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 <br /> Payment Type Check Number Received by <br /> REHS: Date /_/_ Account out: Date <br /> COMMENTS: <br />