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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 1/15/2016 <br />Submitted on: 1/11/2016 2:50:38PM <br />Submitted by: Shelley Gaines Email: shelleygaines@dentoni.com <br />CERS ID: 10182413 <br />Facility ID in CERS: FA0009096 <br />-------------------------------------------------- <br />Accounting: Reviewed by: 15 Date: 1 114 Clerical: <br />Information prior to CIW processing <br />Information after CIW processing <br />CERS <br />OWNER INFORMATION <br />(current EC database) <br />(current submittal) <br />field <br />1921 - HMBP-Regular-Primary Location PR0519380 HAZA SAEED <br />Number of Facilities for this Owner : 1 <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509096 HAZ MAT SJC OES <br />Inactive [ ] [ l <br />Owner ID <br />OW0007096 <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532097 not assigned <br />Inactive <br />Owner name <br />DAVID B DENTONI <br />DAVID B DENTONI <br />111 <br />Mailing address <br />801 S AIRPORT WAY <br />801 S AIRPORT WAY <br />113 <br />STOCKTON, CA 95205 <br />STOCKTON, CA 95205 <br />114, 115, 116 <br />Work phone <br />209-464-4930 <br />209-464-4930 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0009096 <br />Facility name <br />DENTONIS WELDING WORKS INC <br />DENTONIS WELDING WORKS INC <br />3 <br />Site address <br />801 S AIRPORT WAY <br />801 S AIRPORT WAY <br />103 <br />City <br />STOCKTON <br />STOCKTON <br />104 <br />ZIP code <br />95205 <br />95205 <br />105 <br />Facility phone <br />209-464-4930 <br />(209) 464-4930 0 <br />102 <br />Facility mailing address <br />801 SAIRPORT WAY <br />801 SAIRPORT WAY <br />108a <br />STOCKTON, CA 95205 <br />STOCKTON, CA 95205 <br />108b, 108c, 1084 <br />BILLING INFORMATION <br />Contact name <br />DENTONI'S WELDING WORKS INC <br />DENTONI'S WELDING WORKS INC <br />140 <br />Address <br />801 S AIRPORT WAY <br />801 S AIRPORT WAY <br />143 <br />STOCKTON, CA 95205 <br />STOCKTON, CA 95205 <br />144, 145, 146 <br />Contact phone <br />209-943-4836 <br />209-943-4836 <br />141 <br />Contact email <br />SHELLEYGAINES@DENTONI.COM <br />SHELLEYGAINES@DENTONI.COM <br />142 <br />Mail invoices to <br />Account <br />Program record [ ] <br />HMBP } SQG HW [ ] LQG HW [ <br />] RCRA HW New PR#: 4 0 G� 3 <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ <br />] UST New PE: 2`Z� <br />Assigned to: V <br />Please bill: [ ] full calendar year [ ] prorate this calendar year <br />[ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: �,/�'tJ Date: <br />] -. k1; .00 <br />-------------------------------------------------- <br />Accounting: Reviewed by: 15 Date: 1 114 Clerical: <br />[ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified <br />-------------------------------------------------- <br />By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING <br />THROUGH CIW <br />Program Element and Description Record ID Employee name <br />Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location PR0519380 HAZA SAEED <br />Active [ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509096 HAZ MAT SJC OES <br />Inactive [ ] [ l <br />4740 - WASTE TIRE SITE - EXEMPT PR0523804 Garrett Alias -Backus <br />Inactive [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532097 not assigned <br />Inactive <br />