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E_ SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/12/2014 <br /> Submitted on: 3/9/2014 12:44:01PM CERS ID: 10140709 <br /> Submitted by: Robyn West Email: robyn.west@searshc.com Facility ID in CERS: FA0000380 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000311 <br /> Owner name Kmart Corporation Kmart Corporation 111 <br /> Mailing address 3333 Beverly Road, B5-348A 3333 Beverly Road, B5-348A 113 <br /> City Hoffman Estates Hoffman Estates 114 <br /> State IL IL 115 <br /> ZIP code 60179 60179 115 <br /> Work phone 847-286-0037 847-286-0037 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000380 <br /> Facility name Kmart#7486 Kmart#7486 3 <br /> Site address 520 S Cherokee Ln 520 S Cherokee Ln 103 <br /> City Lodi Lodi 104 <br /> Zip code 95240 95240 105 <br /> Facility phone 209-333-0220 209-333-0220 102 <br /> Facility mailing address 520 S Cherokee Ln 520 S Cherokee Ln 108a <br /> City Lodi Lodi 108b <br /> State CA CA 108c <br /> Zip code 95240 95240 108d <br /> BILLING INFORMATION <br /> Contact name Robyn West Robyn West 140 <br /> Address 3333 Beverly Road, B5-348A 3333 Beverly Road, B5-348A 143 <br /> City Hoffman Estates Hoffman Estates 144 <br /> State IL IL 145 <br /> Zip code 60179 60179 146 <br /> Contact phone 847-286-0037 847-286-0037 141 <br /> Contact email robyn&vest@searshc.com robyn.west@searshc.com 142 <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRAHW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST 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: kXIIIJ Date: IO _ <br /> Accounting: Reviewed by: :kL Date:----- Clerical: ] File [ ] Create new file <br /> ----------- <br /> ---_ [ ] A led [ ] Surch erified _--- By: Date_ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1618-RETAIL MKT>2000 SO FT (PREPKGD/LTD PREP) PRO161841 STEPHANIE RAMIREZ Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PRO519900 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO529405 MICHELLE HENRY Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO512119 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509831 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 4557-MED WASTE LIMITED HAULER PRO537988 ROBERT MCCLELLON Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523650 Garrett Alias-Backus Inactive [ ] [ ] <br />