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Date run _3/7/2008 10:50:08AM SAN J(' ' `IUIN COUNTY ENVIRONMENTAL HEP`- —H DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 3/7/20uo 3 <br /> Record Selection Criteria: Facility ID FA0009937 <br /> Make charges/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0003379 New Owner ID <br /> Owner Name KELLOGG SUPPLY INC <br /> Owner DBA KELLOGG GARDEN PRODUCTS <br /> Owner Address 12686 E LOCKE RD <br /> LOCKEFORD, CA 95237 <br /> Home Phone Not Specified <br /> Work/Business Phone -31-083-0220 <br /> Mailing Address 12686 E LOCKE RD <br /> LOCKEFORD, CA 95237 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009937 <br /> Facility Name KELLOGG GARDEN PRODUCTS <br /> Location 12686 E LOCKE RD <br /> LOCKEFORD, CA 95237 <br /> Phone -20-972-7313 <br /> Mailing Address 12686 E LOCKE RD <br /> LOCKEFORD, CA 95237 <br /> Care of <br /> Location Code 99- UNINCORPORATED AREA APN:05132002 <br /> BOS District 004 -VOGEL, KEN SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016937 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name KELLOGG GARDEN PRODUCTS (Circle One) <br /> Account Balance as of 3/7/2008: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2220-SM HW GEN<5 TONS/YR PR0522232 EE0001422-ARIS CACAPIT Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIOIPRO512225 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-OES PR0521028 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARPR0509937 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 283 -AST FAC>/=100 M+ 1 GAL CUMULATIVE PR0522233 EE0001422-ARIS CACAPIT Active Y N A I D <br /> G 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 <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 Ordinace Codes and/or Standards and <br /> State and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: "$372.00= Amount Paid Date <br /> Payment Type Check Number Recei <br /> REHS: �'o' Date / / Account out: Date <br /> COMMENTS: <br /> �) c "2L 4z� 28-31 <br /> \\phs-ehsql-nt\apps\envisions\reports\5021.rpt <br />