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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 9/27/2016 <br /> Submitted on: 9/22/2016 4:02:30PM CERS ID: 10706107 <br /> Submitted by: Jasvir Garcha Email: garchatr@gmail.com Facility ID in CERS: FA0015913 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner : 1 <br /> Owner ID OW0020956 <br /> Owner name Jasvir Garcha Jasvir Garcha 111 <br /> Mailing address 15922 Four Corners Ct 15922 Four Corners Ct. 113 <br /> Lathrop, CA 95330 Lathrop, CA 95330 114, 115, 116 <br /> Work phone 209-215-4000 2092154000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015913 <br /> Facility name Garcha Tires & Repair Garcha Tires & Repair 3 <br /> Site address 1501 W Charter Way 1501 W Charter Way 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209-215-4000 2092154000 102 <br /> Facility mailing address 1501 W Charter Way 1501 W. Charter Way 108a <br /> Stockton, CA 95206 Stockton, CA 95206 108b, 108c,load <br /> BILLING INFORMATION <br /> Contact name Garcha Tires & Repair Jasvir Garcha 140 <br /> Address 1501 W Charter Way 1501 W. Charter Way 143 <br /> Stockton, CA 95206 Stockton, CA 95206 144, 145, 146 <br /> Contact phone Not Specified 2092154000 141 <br /> Contact email garchatr@gmail.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this ndar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: I Date: 0ql�7'll0 <br /> Accounting: Reviewed by: _� Date: IDI341 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 /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PR0527156 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0540911 ONE VACANTi Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523572 HARPRIT MATTU Active [ ] [ ) <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533707 not assigned Inactive [ ] [ ] <br />