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Dale 10/ -014 11:14:33AI SAN J IN COUNTY ENVERONMENTAL HEA, DEPARTMENT Repod#5021 <br /> Run M 1273 Pagel <br /> Facility Information as of 10/9/2014 <br /> Record Selection Criteria: Facility ID FA0001705 <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: 8 SSN/Fed Tax ID <br /> Owner ID OW0001336 New Owner ID <br /> Owner Name Costco Wholesale Corporation <br /> Owner DBA <br /> Owner Address 999 LAKE DR <br /> ISSAQUAH, WA 98027 <br /> Home Phone 425-313-8156 <br /> Work/Business Phone 425-313-8100 <br /> Mailing Address 999 Lake Drive <br /> Issaquah, WA 98027 <br /> Care of Dale Anderson <br /> FACILITY FILE INFORMATION Site Mitigation Facility <br /> Facility ID/CERS ID FA0001705 10146199 <br /> Facility Name Costco Wholesale#38 <br /> Location 1616 E Hammer Ln <br /> Stockton, CA 95210 <br /> Phone 209-478-2040 x <br /> Mailing Address Costco Wholesale Attn: Licensing, PO Box 35( f 2 <br /> Seattle, WA 98124-3405 <br /> care of Costco Wholesale Corporation Ll A_6),A52 N <br /> Location Code 01 -STOCKTON Alt Phone <br /> BOS District 002 -RUHSTALLER, LARRY Fax <br /> APN 09428011 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name COSTCO WHOLESALE CORP <br /> Title <br /> Day Phone 209-478-2040 <br /> Night Phone 209-478-2040 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0001704 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name Costco Wholesale#38 (Clore one) <br /> Account Balance as of 10/9/2014: $0.00 <br /> (Cirde One) <br /> Transfer to Aetive/InacNe <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1619-RETAIL MKT>1000 SQ FT(=/>2 DEPTS) PRO160939 EE0001084-STEPHANIE RAMIREZ Active Y N A I D <br /> 1633-FOOD VEHICLEICART(LTD FOOD PREP) PRO163133 EE0001084-STEPHANIE RAMIREZ Inactive Y N A I D <br /> 1635-MOBILE FOOD PREPARATION UNIT(MFPU) PRO160999 EE0001084-STEPHANIE RAMIREZ Inactive Y N A I D <br /> 1921 -HMBP-Regular-Primary Location PR0519873 EE0000006-HAZA SAEED Active Y N A I D <br /> 2220-SM HW GEN<5 TONSNR PRO517875 EE0005642-MICHELLE HENRY Active Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO512073 EE0000000-HAZ MAT SJC OES Inactive Y N A 1 D <br /> 2226-CaIARP PROGRAM PRO514673, EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 2371 -UST FACILITY-1702 COMPLIANT PRO518624 EE0000005-FATINAH ZAREEF Active Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE F PRO509785 EE0000000-HAZ MAT SJC OES Inactive Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PR0522399 EE0002622-BENJAMIN ESCOTTO Active Y N A I D <br /> ERSC-ELECTRONIC REPORTING ATATE SURCHARG PR0533728 l Iruactiv, Y N A I D <br />