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Date mn 5/22/2014 1:41:02PR SAN JO . UIN COUNTY ENVIRONMENTAL FIEAL_d DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 5/22/2014 <br /> Record Selection Criteria: Facility ID FA0015750 <br /> Make changeslcorrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 2 SSN/Fed Tax ID <br /> Owner ID OW0012681 New Owner ID <br /> Owner Name THE HOME DEPOT USA, INC. <br /> Owner DBA HOME DEPOT <br /> Owner Address 3207 GREYHAWK CT 200 <br /> CARLSBAD, CA 92010 <br /> Home Phone Not Specified <br /> Work/Business Phone 770-433-8211 <br /> Mailing Address 2455 PACES FERRY ROAD, C-19 <br /> ATLANTA, GA 30339 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility lD/CERS ID FA0015750 10140273 <br /> Facility Name THE HOME DEPOT DISTRIBUTION CENTEF <br /> Location 18300 S Harlan Rd <br /> Lathrop, CA 95330 <br /> Phone 209-858-9243 x <br /> Mailing Address 160 Chapel Road, Suite 201 c/o Compliance C <br /> Manchester, CT 06042 <br /> Care of THE HOME DEPOT USA, INC. <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0027282 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility ! Account <br /> Account Name THE HOME DEPOT DISTRIBUTION CENTER#536: (Circle One) <br /> Account Balance as of 5/22/2014: $0.00 <br /> (Circle One) <br /> Transfer to ActivellnacNe <br /> PrograMElemenl and Description Record ID Employee ID and Name Status New Owner' Delete <br /> 1921 -HMBP-Reqular-Primary Location PR0523321 EE0002474-MICHAEL PARISSI Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PR0535762 EE0005642-MICHELLE HENRY Active Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PRO527995 EE0002620-ALFONSO ARAMBULA Inactive Y N A I D <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARG PR0533230 Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,Ne undersigned owner,operator or agent of same,acknowledge that all site,andior 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 tartly that all operations will be performed in acro dance with all applicable Ordinance Codes andfor Standards and State andlor <br /> Fetleral Laws <br /> APPLICANT'S SIGNATURE: Date <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date / / <br /> Water System to be TRANSFERED: Amount Paid Date <br /> Payment Type Check Number Remiv '/ <br /> REHS Date / / Account out: Date O/�/it <br /> COMMENTS: <br />