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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Changes to EnvisionConnect by CERS Integration Wizard Date run: 7/11/2017 Submitted on: 7/10/2017 5:15:55PM CERS ID: 10184481 Submitted by: STEINHART STEINHART Email: steinhart4@sbcglobal.net Facility ID in CERS: FA0013641 OWNER INFORMATION Owner ID Owner name Mailing address Work phone Information prior to CIW processing (current EC database) Number of Facilities for this Owner : 1 OW0010754 ZUCKERMAN HERITAGE, INC PO BOX 487 STOCKTON, CA 95201 209-469-7979 FACILITY FILE INFORMATION Facility ID FA0013641 Facility name DELTA BLUEGRASS CO Site address 1030 S ARGONAUT City STOCKTON ZIP code 95204 Facility phone 209-469-7979 Facility mailing address PO BOX 487 [ ] Acct billed [ ] Surcharge verified STOCKTON, CA 95201 BILLING INFORMATION ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Contact name KELLY DAVIS Address PO BOX 487 1921 - HMBP-Regular-Primary Location 6 chem units PR0521045 ROBERT LOPEZ STOCKTON, CA 95201 Contact phone 209-469-7979 Contact email KDAVIS@DELTABLUEGRASS.COM Mail invoices to Account Information after CIW processing CERS (current submittal) field ZUCKERMAN HERITAGE, INC 111 PO BOX 487 113 Stockton, CA 95219 114, 115, 116 209-469-7979 112 DELTA BLUEGRASS CO 3 1030 S ARGONAUT 103 STOCKTON 104 95204 105 209-469-7979 102 PO BOX 487 108a STOCKTON, CA 95201 108b, 108c, 108d Trey Steinhart 140 PO Box 487 143 Stockton, CA 95219 144, 145, 146 2094697979 141 steinhart4@sbcglobal.net 142 Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PR#: New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing te Processed through CERS Integration Wizard by: ' /$�,A C.;-- Date: T I H-7 7112,)1'7 Accounting: Reviewed by: Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file [ ] Acct billed [ ] Surcharge verified By: Date: ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Record ID Employee name Status Reactivated Inactivated 1921 - HMBP-Regular-Primary Location 6 chem units PR0521045 ROBERT LOPEZ Active [ ] [ ] 2220 - SM HW GEN <5 TONS/YR PR0540116� STACY RIVERA Active [ ] [ ] 2831 -AST FAC >/= 1,320 - <10 K GAL CUMULATIVE PR0540726 ✓ STACY RIVERA Active [ ] [ ] 4740 - WASTE TIRE SITE - EXEMPT PR0534992 HARPRIT MATTU Active [ ] [ ] 2224 - HAZ MAT BUSINESS PLAN AUTHORIZATION PRO517983 HAZ MAT SJC DES Inactive [ ] [ ] 2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO517984 HAZ MAT SJC DES Inactive [ ] [ ] ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PRO533129 not assigned Inactive [ ] [ ]