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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/10/2017 <br /> Submitted on: 12/20/2016 2:55:37PM CERS ID: 10182751 <br /> Submitted by: glenda Roe Email: groe@midstatesteel.net Facility ID in CERS: FA0009521 <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 OW0007521 <br /> Owner name GERALD SHIPMAN GERALD SHIPMAN 111 <br /> Mailing address 1916 CHEROKEE RD 1916 CHEROKEE RD 113 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 114, 115, 116 <br /> Work phone 209-464-9497 (209)464-9497 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009521 <br /> Facility name MID-STATE STEEL ERECTORS INC MID-STATE STEEL ERECTORS INC 3 <br /> Site address 1916 CHEROKEE RD 1916 CHEROKEE RD 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-464-9497 (209)464-9497 102 <br /> Facility mailing address 1916 CHEROKEE RD 1916 CHEROKEE RD 108a <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 108b, 108c,coed <br /> BILLING INFORMATION <br /> Contact name MID-STATE STEEL ERECTORS INC MID-STATE STEEL ERECTORS INC 140 <br /> Address 1916 CHEROKEE RD 1916 CHEROKEE RD 143 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 144, 145. 146 <br /> Contact phone 209-464-9497 (209)464-9497 141 <br /> Contact email 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: f RD S`11 5 ` ' .I <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: 22-L'a <br /> Assigned to: (:::Ni.,LC, r <br /> Please bill: full calendar year [ ] prorate,,this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: VA Date: 1 • ID-Cl <br /> -------------------------------------- <br /> Accounting: Reviewed by: II�J Date: 'hDh7 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 8 chem units PRO519697 HAZA SAEED Active [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0528483 TIMOTHY ENGLE Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO511809 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509521 HAZ MAT SJC DES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO533941 not assigned Inactive [ ] [ ] <br />