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SAN ,JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 5/10/2016 <br />Submitted on: 3/31/2016 7:17:19AM <br />Submitted by: gage stahlberg Email: gstahlberg@kpaonline.com <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner : 1 <br />OW0008988 <br />DORNOCH INC <br />3500 AUTO PLAZA WAY <br />TRACY, CA 95304 <br />209-835-4821 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0010988 <br />Facility name <br />TRACY FORD <br />Site address <br />3500 AUTO PLAZA WAY <br />City <br />TRACY <br />ZIP code <br />95304 <br />Facility phone <br />209-835-4821 <br />Facility mailing address 3500 AUTO PLAZA WAY <br />CERS ID: 10184015 <br />Facility ID in CERS: FA0010988 <br />Information after CIW processing CERS <br />(current submittal) field <br />DORNOCH INC 111 <br />3500 AUTO PLAZA WAY 113 <br />TRACY, CA 95304 114, 115, 116 <br />209-835-4821 112 <br />TRACY FORD 3 <br />3500 AUTO PLAZA WAY 103 <br />TRACY 104 <br />95304 105 <br />209-835-4821 102 <br />3500 AUTO PLAZA WAY 108a <br />TRACY, CA 95304 108b, 108c, 108d <br />Maria Mueller 140 <br />3500 AUTO PLAZA WAY 143 <br />TRACY, CA 95304 144, 145, 146 <br />209-835-4821 141 <br />mmueller@tracyford.com 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br />TRACY, CA 95304 <br />BILLING INFORMATION <br />Contact name <br />Maria Mueller <br />Address <br />3500 AUTO PLAZA WAY <br />TRACY, CA 95304 <br />Contact phone <br />209-835-4821 <br />Contact email <br />mmueller@tracyford.com <br />Mail invoices to <br />Account <br />CERS ID: 10184015 <br />Facility ID in CERS: FA0010988 <br />Information after CIW processing CERS <br />(current submittal) field <br />DORNOCH INC 111 <br />3500 AUTO PLAZA WAY 113 <br />TRACY, CA 95304 114, 115, 116 <br />209-835-4821 112 <br />TRACY FORD 3 <br />3500 AUTO PLAZA WAY 103 <br />TRACY 104 <br />95304 105 <br />209-835-4821 102 <br />3500 AUTO PLAZA WAY 108a <br />TRACY, CA 95304 108b, 108c, 108d <br />Maria Mueller 140 <br />3500 AUTO PLAZA WAY 143 <br />TRACY, CA 95304 144, 145, 146 <br />209-835-4821 141 <br />mmueller@tracyford.com 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] <br />next calendar year [ ] exempt from billing <br />0 <br />Processed through CERS Integration Wizard by: Date: <br />------------------------------- <br />Accounting: Reviewed by: V� Date: ��i2h a Clerical: <br />[ ] File [ ] Relabel file [ ] Create new file <br />[ rch rrified <br />By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name <br />Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location PR0520590 PETER LOMBARDI <br />Active [ ] [ ] <br />2228 - GEN 25<50 TONS PERMIT PR0514484 VICKI MCCARTNEY <br />Active [ ] [ ] <br />2831 - AST FAC >/= 1,320 - <10 K GAL CUMULATIVE PR0528233 VICKI MCCARTNEY <br />Active [ ] <br />4740 - WASTE TIRE SITE - EXEMPT PR0522404 ALFONSO ARAMBULA <br />Active [ ] [ J <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510988 HAZ MAT SJC OES <br />Inactive [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PRO534536 not assigned <br />Inactive [ ] [ ] <br />