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Date run 3/29/2019 11:16:07Af SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 3/29/2019 <br /> Record Selection Criteria: Facility ID FA0020265 <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: 1 SSN/Fed Tax ID <br /> Owner ID OW0016636 New Owner ID <br /> Owner Name David Ramsey <br /> Owner DBA RAMSEY EXPRESS TRUCKING <br /> OwnerAddress 5407 CLARIBEL RD <br /> MODESTO, CA 95357 <br /> Work/Business Phone 209-460-1627 <br /> Alternative Phone 209-652-5770 <br /> Mailing Address 5407 Claribel Rd. <br /> Modesto, CA 95357 <br /> Care of <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0020265 10705552 <br /> Facility Name Ramsey Express Trucking, Inc. <br /> Location 618 McCloy Ave <br /> Stockton, CA 95203 <br /> Phone 209-460-1627 x <br /> Mailing Address 618 MCCIOy <br /> Stockton, CA 95203 <br /> Care of Ramsey Express Trucking, Inc. <br /> Location Code 01 - STOCKTON Alt Phone <br /> BOS District 003 - PATTI, TOM 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 AR0036182 NewAccount ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name David Ramsey (Circle One) <br /> Account Balance as of 3/29/2019: $0.00 <br /> (Circle One) <br /> Transfer to Active/Inactve <br /> Program/Element and Description Record ID Employee ID and Name Status New Owner? Delete <br /> 1921 -HMBP-Regular-Primary Location PR0541174 EE0009817-ROBERT LOPEZ Active Y N A I D <br /> 2220-SM HW GEN <5 TONS/YR PR0539731 EE0001421 -STACY RIVERA Active Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PR0535056 EE0002622-BENJAMIN ESCOTTO ' Inactive Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific,PHS/EHD 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 and/or <br /> Federal 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 Received by <br /> EHD Staff: Date / / Account out: Date <br /> COMMENTS: <br /> Invoice#: <br />