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Date run 11/8/2013 9:37:02AIt SAN JO 'JIN COUNTY ENVIRONMENTAL,HEA'` �DEPARTMENT Report#5021 <br /> Run by N0011,,./ Pagel <br /> Facility Information as of 11/8/2013 <br /> Record Selection Criteria: Facility ID FA0013436 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION SSNI Fed Tax ID <br /> Owner ID OW0016107 New Owner ID <br /> Owner Name HORTON. KENNETH D <br /> Owner DBA NORTON CONSTRUCTION <br /> Owner Address 6987 PEZZI RD <br /> STOCKTON, CA 95215 <br /> Home Phone Not Specified <br /> Work/Business Phone 209-931-1620 <br /> Mailing Address 6987 PEZZI RD <br /> STOCKTON, CA 95215 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID 1 CERS ID FA0013436 10,184,363 <br /> Facility Name HORTON CONSTRUCTION <br /> Location 1020 E CHARTER WAY <br /> STOCKTON, CA 95206 <br /> Phone 209-481-6918 x0 _ <br /> Mailing Address 6987 PEZZI RD <br /> STOCKTON, CA 95215 <br /> Care of <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 001 -VILLAPUDUA Fax <br /> APN 16902004 EMaii: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0022455 New Account ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner I Facility 1 Account <br /> Account Name NORTON, KENNETH D (Circle One) <br /> Account Balance as of 111812013: $0.00 <br /> (Circle One) <br /> Transfer to Activelnactve <br /> ProgramlElement and Description Record ID Employee ID and Name Status New Owner? Delete <br /> HMBP-Regular-Primary Location PRO521147 EE0009817-ROBERT LOPEZ Active Y N A I D <br /> S2220-_HAZ <br /> MHWGEN<5 TONS/YR PRO517457 EE0001421 -STACY RIVERA Inactive Y N I D <br /> MAT BUSINESS PLAN AUTHORIZATION PR0517564 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PRO517458 EE0007289-ALISON YOUNGBLOOD Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PRO534225 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,andlor project specific.PHSIEHD 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 and/or Standards and State andlor <br /> Federal Laws, <br /> APPLICANTS SIGNATURE: Date 1 ! <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date I I <br /> Water System to be TRANSFERED: Amount Paid Date 1 I <br /> Payment T e heck Number Recei e <br /> REHS: Date�_11�1�3 Account out: Date I_/.S/_l'3 <br /> COMMENTS: <br /> Q "s rnesj <br /> D u r i l� � 2 MAS l- Tin S pe(4 i n . <br />