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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 5/25/2017 <br />Submitted on: 5/19/2017 1:31:10PM <br />Submitted by: Annette Niemiec Email: annette.niemiec@poolcorp.com <br />CERS ID: 10408546 <br />Facility ID in CERS: FA0019707 <br />FA0019707 <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 />95206 <br />Number of Facilities for this Owner: 1 <br />800-351-5470 <br />985-801-5714 <br />Owner ID <br />OW0016164 <br />Mail invoices to <br />Account <br />Owner name <br />Superior Pool Products LLC <br />Superior Pool Products LLC <br />111 <br />Mailing address <br />109 Northpark Blvd. <br />109 Northpark Blvd. <br />113 <br />Covington, LA 70433 <br />Covington, LA 70433 <br />114, 115, 116 <br />Work phone <br />985-892-5521 <br />985-892-5521 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0019707 <br />Facility name <br />General Pool & Spa Supply <br />Site address <br />2414 Boeing Way Ste 100 <br />City <br />Stockton <br />ZIP code <br />95206 <br />Facility phone <br />800-351-5470 <br />Facility mailing address <br />2414 Boeing Way Ste 100 <br />2414 Boeing Way Ste 100 <br />Stockton, CA 95206 <br />BILLING INFORMATION <br />104 <br />Contact name <br />Annette Niemiec <br />Address <br />109 Northpark Blvd., Suite 123 <br />Covinton, LA 70433 <br />Contact phone <br />985-801-5714 <br />Contact email <br />annette.niemiec@poolcorp.com <br />Mail invoices to <br />Account <br />Superior Pool Products LLC <br />3 <br />2414 Boeing Way Ste 100 <br />103 <br />Stockton <br />104 <br />95206 <br />105 <br />800-351-5470 x252901 <br />102 <br />2414 Boeing Way Ste 100 108a <br />Stockton, CA 95206 108b, 108c, 108d <br />Annette Niern ec <br />140 <br />109 Northpark Blvd., Suite 123 <br />143 <br />Covinton, LA 70433 <br />144, 145, 146 <br />985-801-5714 <br />141 <br />annette.niemiec@poolcorp.com <br />142 <br />Program record [ ] HMBP [ ] SCG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />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: 0,L�L— Date: — ( 7 <br />---------------- <br />Accounting:Reviewed by: Date: U�— <br />/7 Clerical: [ ]File [ ]Relabel file [ ]Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location 11 chem units PRO529870 ROBERT LOPEZ Active [ ] [ ] <br />4740 - WASTE TIRE SITE - EXEMPT PR0535694 BENJAMIN ESCOTTO Active [ ] [ ] <br />6 �an9e t t=rr((�'�� ^°kq t,1�s�v2� 1J, lvonasSl� �n4()cok,ry �o,M +� <br />