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Data An 10/21/2002 1:49:18P SAN JWIN COUNTY ENVIRONMENTAL HEReport#5021 <br /> EPARTMENT Pagel <br /> nun by <br /> Facility Information as of 10/21/ <br /> Record Selection Criteria: Fa&y ID FA0009860 <br /> Make changestcorrections in RED Ink or pencil. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION <br /> Owner ID OW0007860 New Owner ID <br /> Owner Name MCLAUGHLIN, DANNY <br /> Owner DBA MCLAUGHLIN REFUSE EQUIP, INC <br /> Owner Address <br /> Home Phone 209-333-4414 <br /> Work/Business Phone Not Specified <br /> Mailing Address PO BOXY' <br /> GALT, CA 95632 c R R 5 -'2 3 7 <br /> Care of DANNY MCLAUGHLIN <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009860 <br /> Facility Name MCLAUGHLIN REFUSE EQUIP, INC <br /> Location 11900 E LOCKE RD <br /> LOCKEFORD, CA 95237 20 <br /> Phone 209-333-4414 <br /> Mailing Address &OfBOX 637-' f'd ox IQ b <br /> GALT,,-CA-95632 - �0,Kr-forL CR 95a. 37 <br /> Care of DANNY MCLAUGHLIN <br /> Location Code 99 - UNINCORPORATED AREA APN 051-160-04 <br /> BOS District 004-SEIGLOCK, JACK SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0016860 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name MCLAUGHUN REFUSE EQUIP, INC (Circle One) <br /> Account Balance as of 10/21/2002: $0.00 <br /> (Circle one) <br /> Trawler r ActNe e <br /> NewOwner? <br /> Owner? Deletetete <br /> Program/Element and Description Record ID Employee ID and Name Status <br /> 2220-SM HW GEN<5 TONS/YR PRO514065 EE0003580-MICHELLE STERNI-LE Inactive Y N A I D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PRO512148 EE0000000-HAZ MAT SJC DES Active Y N A I D <br /> 2227-GEN 5<25 TONS PERMIT PRO505913 EE0000008-LETITIA BRIGGS Inactive Y N A I D <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE FPRO509860 EE0000000-HAZ MAT SJC OES Active Y N A I D <br /> 4630-NTNC WATER SYSTEM WA0515511 EE0005838-ADRIENNE ELLSAESSEActive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all she,and/or project specific,PHS/EHD houriycharges associated with this <br /> facility or activity will be billed to the party identified as the OWNER on this form. I also certiy that all operations will be performed in accordance with all applicable Ordinate Codes and/or Standards and <br /> state and/or Federal Laws. <br /> APPLICANTS SIGNATURE: Date /___J <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: `$155.00= Amount Paid Date <br /> Payment Type Check Number Receiv <br /> REHS: Date____j_J Account out: Date <br /> COMMENTS: <br /> \\Phs-ehsgl-nt\apps\Envisions\Reports\5021.rpt <br />