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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 5/12/2017 <br /> Submitted on: 5/10/2017 1:33:04PM CERS ID: 10667236 <br /> Submitted by: Thomas Leung Email: thomas@frogenv.com Facility ID in CERS: FA0010231 <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 OW0008231 <br /> Owner name Beacon Sales Acquisition, Inc. Beacon Sales Acquisition, Inc. 111 <br /> Mailing address 505 Huntmar Park Drive, Suite#300 505 Huntmar Park Drive, Suite#300 113 <br /> Herndon, VA 20170 Herndon, VA 20170 114, 115, 116 <br /> Work phone 571-323-3939 (571) 323-3939 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010231 <br /> Facility name ROOFING SUPPLY GROUP-STOCKTON Roofing Supply Group-Sockton 3 <br /> Site address 2081 E CHARTER WAY 2081 E Charter Way 103 <br /> City STOCKTON Stockton 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-948-9241 (209) 946-4214 102 <br /> Facility mailing address 505 HUNTMAR PARK DR STE 300 2081 E Charter Way 108a <br /> HERNDON, VA 20170 Stockton, CA 95205 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name ROOFING SUPPLY GROUP-STOCKTON Jeff Coffey 140 <br /> Address 2081 E CHARTER WAY 2081 E Charter Way 143 <br /> STOCKTON, CA 95205 Stockton, CA 95205 144, 145, 146 <br /> Contact phone Not Specified (209) 946-4214 141 <br /> Contact email jcobb@rsgroof.com matt@pacificsupply.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] proratethiscalendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: /%,^^ A-9-- Date: 541-0 <br /> Accounting: Reviewed by: 'SIJ Date: 511111-7 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 1 chem units PR0520172 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0514240 THREE VACANT3 Inactive [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512519 THREE VACANT3 Inactive [ ] [ ] <br /> 2226-CaIARP PROGRAM PR0514746 THREE VACANT3 Inactive [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0231942 LETITIA BRIGGS Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510231 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2831 -AST FAC >/= 1,320-<10 K GAL CUMULATIVE PR0515877 JEFFREY WONG Inactive [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0524698 JENNIFER FRASE Inactive [ ] [ ] <br />