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Date run ��.,,�OOif 9:14:184 SAN JOA—'TN COUNTY ENVIRONMENTAL HEALTH' DEPARTMENT Repon 95021 <br /> Run by Pagel <br /> Facility klformation as of 2/25/200&-,/ <br /> Record Selection Criteria: Facility ID FA0010111 <br /> Make changes/corrections in RED ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0008111 New Owner ID <br /> Owner Name STOCKTON INTER TRANS CORP <br /> Owner DBA YELLOW CAB <br /> Owner Address 5000 S AIRPORT WAY 205 <br /> STOCKTON, CA 95206 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-462-8700 <br /> Mailing Address 6500 LINDBERGH ST <br /> STOCKTON, CA 952064928 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010111 <br /> Facility Name YELLOW CAB <br /> Location 7030 S C E DIXON ST <br /> STOCKTON, CA 95206 <br /> Phone 209-462-8700 <br /> Mailing Address 6500 LINDBERGH ST <br /> STOCKTON, CA 952064928 <br /> Care of <br /> Location Code 99- UNINCORPORATED AREA APN 17726026 <br /> BOS District 001 -GUTIERREZ, STEVE SIC Code:9900 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0017111 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name YELLOW CAB (Circe One) <br /> Account Balance as of 2/25/2008: $552.00 <br /> (Circe One) <br /> Transfer to Active/Inacive <br /> Prograndeemant and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 2220-SM HW GEN<5 TONS/YR PR0514174 EE0002670-MUNIAPPA NAIDU Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHOR17ATIOIPRO512399 EEOOOOOOO-HAZ MAT SJC DES Inactive Y N A I D <br /> 2244-PACT TRANSFER RECORD-DES PR0520874 EEOOOOOOO-HAZ MAT SJC DES Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARPRO510111 EE0000000-HAZ MAT SJC DES Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned ovmer,operator or agent of same,acknowledge that all site,and/or project specific,PHS/EHD hourly charges associated witn this <br /> facility or activity vAll be billed to the parry identified as the OWNER on this form. 1 also certify that all operations will be performed in accordance with all applicable Ort ince Codes amVor Standards and <br /> Stale and/or Federal Laws. <br /> APPLICANTS SIGNATURE: Date / — -- <br /> - ^ ^ 4 <br /> Program Records to be TRANSFERED: `$20.00= Amount Paid Date_ d I d 5 t O�—='-- <br /> Water System to be TRANSFERED: '$372.00= Amount Paid Date /. <br /> Payment Type Check Number Received by �_�^ \ <br /> REHS: Date / / Account out: Dab S e C� Q�@ 99 L <br /> COMMENTS: � Z4 <br /> N�'JO ,yrs <br /> \\phs-ehsgl-nt\apps\envisions\reports\5021.rpt <br />