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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 12/2/2014 <br /> Submitted on: 12/1/2014 10:17:33AM CERS ID: 10183035 <br /> Submitted by: Sultan Jackson Email: sjackson@duraflame.com Facility ID in CERS: FA0009922 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0007199 <br /> Owner name DURAFLAME INC DURAFLAME INC 111 <br /> Mailing address PO BOX 1230 PO BOX 1230 113 <br /> STOCKTON, CA 95201-1230 STOCKTON, CA 95201-1230 114, 115, 11E <br /> Work phone 209-461-6600 2095472699 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009922 <br /> Facility name DURAFLAME DURAFLAME 3 <br /> Site address 2533 S AIRPORT WAY 2533 S AIRPORT WAY 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209-547-2699 (209) 547-2699 102 <br /> Facility mailing address PO BOX 1230 PO BOX 1230 108a <br /> STOCKTON, CA 95201 STOCKTON, CA 95201 100b,108c,toe <br /> BILLING INFORMATION <br /> Contact name DURAFLAME DURAFLAME 140 <br /> Address PO BOX 1230 PO BOX 1230 143 <br /> STOCKTON, CA 95201 STOCKTON, CA 95201 144, 145, 14( <br /> Contact phone 209-547-2699 2095472699 141 <br /> Contact email 142 <br /> Mail invoices to . )Nw <br /> Program record ( ] HMBP [ I SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: 1111, i1/1 Date: 12 111-1 <br /> Accounting: Reviewed by: Date: ja� Clerical: [�, File [ ] Relabel file Create new <br /> \ [ ] file <br /> [ ] Acft-trlf� [ ] Surcl a fled By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PRO519963 ROBERT LOPEZ Active [ I [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO534898 BENJAMIN ESCOTTO Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO509922 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPOTTING STATE SURCHARGE FI PR0532642 not assigned Inactive [ ] [ ] <br />