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1 <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 5/24/2017 <br />Submitted on: 5/22/2017 3:06:30PM CERS ID: 10646032 <br />Submitted by: Farah Khwaja Email: farahkhwaja@aol.com Facility ID in CERS: FA0015710 <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 />OW0012640 <br />CALIFORNIAAUTO SPORTS <br />5602 NATOMACIR <br />STOCKTON, CA 95219-7119 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0015710 <br />Facility name <br />CALIFORNIAAUTO SPORTS <br />Site address <br />180 BUTTON AVE <br />City <br />MANTECA <br />ZIP code <br />95336 <br />Facility phone <br />209-665-7247 <br />Facility mailing address 5602 NATOMACIR <br />STOCKTON, CA 95219-7119 <br />BILLING INFORMATION <br />Contact name CALIFORNIAAUTO SPORTS <br />Address 5602 NATOMACIR <br />STOCKTON, CA 95219-7119 <br />Contact phone Not Specified <br />Contact email <br />Mail invoices to Far <br />i#11y �} <br />Information after CIW processing CERS <br />(current submittal) field <br />Umar Khan <br />111 <br />1431 Ponce Deleon Ave <br />113 <br />STOCKTON, CA 95209 <br />114, 115, 116 <br />2094200944 <br />112 <br />IN N OUT AUTOMOTIVE 3 <br />180 BUTTON AVE 103 <br />MANTECA 104 <br />95336 105 <br />209-665-7247 102 <br />180 Button Ave 108a <br />Manteca, CA 95336 10eb, toec, toed <br />Yusaf Khan <br />140 <br />1431 PONCE DE LEON AVE <br />143 <br />MANTECA, CA 95336 <br />144, 145, 146 <br />2094200944 <br />141 <br />californiaautosport209@gmail.com <br />142 <br />Program record [ <br />] HMBP <br />p`] SQG HW [ <br />] LQG HW [ ] RCRA HW New PR#: <br />created [ <br />] Tiered permit <br />[ ] APSA [ <br />] CalARP [ ] UST New PE: <br />0 <br />Assigned to: <br />P(LArJ12 <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: tDate: <br />Accounting: Reviewed by: Date: ��1 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 />1920 - HMBP-Common Materials 5 chem units PR0540422 NICHOLAS LOEHRER Active <br />4740 - WASTE TIRE SITE - EXEMPT PRO523263 HARPRIT MATTLI Active [ ] [ ] <br />4) o -7 � J <br />