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Data nun 2/14/2017 2:50:23PR SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Reponp50211 <br /> Run by Pagel <br /> Facility Information as of 2/14/2017 <br /> Record Selection Criteria. Facility ID FA0021991 <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 OW0018105 New Owner ID <br /> Owner Name JASHSINGH <br /> Owner DBA <br /> Owner Address PO BOX 21 <br /> TRACY, CA 95378 <br /> Home Phone 209-855-3700 <br /> Work/Business Phone 209-855-3700 <br /> Mailing Address PO BOX 21 <br /> TRACY, CA 95377 <br /> Care of SINGH, JASHARINDERPAL <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0021991 10462897 <br /> Facility Name Destination Anywhere Inc <br /> Location 28818 S CORRAL HOLLOW RD <br /> Tracy, CA 95377 <br /> Phone 209-836-9400 x <br /> Mailing Address p0 box 21 <br /> TRACY, CA 95377 <br /> Care of JasharinderpalSINGH <br /> Location Code Alt Phone <br /> BOS District Fax <br /> APN EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name SONY MANN AKA JASHARINDERPAL SINGI <br /> Title OWNER 117 5z <br /> /� �aq r <br /> Day Phone 209-836-9400 —�FL L R C 3 0 fl- <br /> 411 T <br /> Night Phone 209-855-3700 <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0040094 New Account ID: <br /> Mail Invoices to Account Mail Invoices to: Owner / Facility / Account <br /> Account Name JASHSINGH (Circle 0.) <br /> Account Balance as of 2/14/2017: $615.00 <br /> (Circle One) <br /> ProgreMElemmt and Description Rewrd ID EmployTrensferto Active/Inactve <br /> ee ID end Name Status New OymeR Delete <br /> 1921 -HMBP-Regular-Primary Location PRO538071 EE0000009-NICHOLAS LOEHRER Active Y N A I D <br /> 2220-SM HW GEN<5 TONS/YR PRO538072 EE0000016-BETTY HO Active Y N A I D <br /> 4740-WASTE TIRE SITE-EXEMPT PR0540311 EE0009000-HARPRIT MATTU Active Y N A I D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,the undersigned owner,operator or agent of same,acknowledge that all site,anNor project specific,PHSEHO hourly charges associated with this facility or: <br /> be billed to Ne party identified as the OWNER on this form. 1 also certify that all operations will be performed in accordance with all applicable Ordinance Codes andror Standards and State andior Federal Lewis <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 />