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_ Z ' <br /> Date run 8/3/2010 10:23:43AM SAN JO/' IN COUNTY ENVIRONMENTAL HEAL- DEPARTMENT Report a5021 <br /> Run by Pagel <br /> Facility Information as of 8/3/2010 <br /> Record Selection Criteria: Facility 10 FA0019992 <br /> Make changeslcorrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSN I Fed Tax ID <br /> Owner ID OW0002215 New Owner ID <br /> Owner Name ARNAUDO BROS <br /> Owner DBA ARNAUDO BROS <br /> Owner Address 16505 TRACY BLVD <br /> I TRACY, CA 95376 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-835-0406 <br /> Mailing Address 16505 TRACY BLVD <br /> TRACY, CA 95376 <br /> Care of ARNAUDO BROS <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019992 <br /> Facility Name ARNAUDO BROS TRUCKING <br /> Location 17190 S TRACY BLVD <br /> TRACY, CA 95304 <br /> Phone 209-835-0406 <br /> Mailing Address '16505 S TRACY BLVD <br /> TRACY, CA 95304 <br /> Care of ARNAUDO BROS <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN 18924018 EMail: <br /> I EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name JOE ENOS IV71W <br /> Title <br /> Day Phone C2p 45-0 . <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0035589 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner 1 Facility I Account <br /> Account Name ARNAUDO BROS TRUCKING (Circle One) <br /> Account Balance as of 81312010: $0.,00 <br /> (Circle One) <br /> Transfer to Aetivellnactve <br /> ProgramlElement and Description Record ID Employee iD and Name Status New Owner? Delete <br /> 2220-SM HW GEN<5 TONSIYR PRO530986 EE0001421 -STACY RIVERA Active Y N A I D <br /> 2830-AST FAC -SPCC EXEMPT PRO530985 EE0001421 -STACY RIVERA Active,Exempt Y N A I D <br /> ERSC-ELECTRONIC REPORTING SURCHARGE PRO533385 Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific,PHSlEHD hourly charges associated with this <br /> facility 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 Ordinate Codes and/or Standards and <br /> State andlor Federal Laws, <br /> APPLICANTS SIGNATURE: Date / 1 <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date 1. 1 <br /> Water System to be TRANSFERED: `$372.00= Amount Paid Date / ! <br /> Paym t Type (umber Recei y <br /> REHS: Date P 1 J Account out: _ Date 1 1 <br /> COMMENTS: <br /> Ileh-envkenvision\reportsk502l.rpt <br />