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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 10/19/201E <br />Submitted on: 10/12/2016 3:42:56PM CERS ID: 10182863 <br />Submitted by: Pick -n -Pull Auto Dismantlers (A California General Partnership) Email: environr Facility ID in CERS: FA0009750 <br />FA0009750 <br />Information prior to CIW processing <br />Information after CIW processing <br />CERS <br />OWNER INFORMATION <br />(current EC database) <br />(current submittal) <br />field <br />4223 E CLARK DR <br />Number of Facilities for this Owner : 1 <br />103 <br />City <br />Owner ID <br />OW0007750 <br />104 <br />ZIP code <br />Owner name <br />Pick -n -Pull Auto Dismantlers <br />Pick -n -Pull Auto Dismantlers <br />111 <br />Mailing address <br />10850 Gold Center Drive, Suite 325 <br />10850 Gold Center Drive, Suite 325 <br />113 <br />4223 Clark Drive <br />Rancho Cordova, CA 95670 <br />Rancho Cordova, CA 95670 <br />114, 115, 116 <br />Work phone <br />916-858-3100 <br />916-858-3100 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0009750 <br />SSI - Accounts Payable ✓ <br />140 <br />Facility name <br />PNP Stockton Premier <br />PNP Stockton Premier <br />3 <br />Site address <br />4223 E CLARK DR <br />4223 E CLARK DR <br />103 <br />City <br />STOCKTON <br />STOCKTON <br />104 <br />ZIP code <br />95215 <br />95215 <br />105 <br />Facility phone <br />209-466-5621 <br />209-466-5621 <br />102 <br />Facility mailing address <br />4223 Clark Drive <br />4223 Clark Drive <br />108a <br />HAZ MAT SJC OES <br />Stockton, CA 95215 <br />Stockton, CA 95215 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name <br />Charina Gaspay <br />SSI - Accounts Payable ✓ <br />140 <br />Address <br />10850 Gold Center Drive, Suite 325 <br />10850 Gold Center Drive, Suite 325 <br />143 <br />By: Date: <br />Rancho Cordova, CA 95670 <br />Rancho Cordova, CA 95670 <br />144, 145, 146 <br />Contact phone <br />916-204-7625 <br />916-204-7625 <br />141 <br />Contact email <br />environmental@picknpull.com <br />corpap@schn.com ✓ <br />142 <br />Mail invoices to <br />Account <br />2217 - APPLIANCE RECYCLER <br />PR0521482 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />Please bill: [ ] full calendar year [ ] prorate this <br />New PR#: <br />New PE: <br />Assigned to: <br />year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: <br />P k, <br />Date: <br />Accounting: Reviewed by: Date: 0 Clerical: [ <br />] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge <br />------------------------------------------------------ <br />veri ied <br />By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description <br />Record ID <br />Employee name <br />Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location <br />PR0519846 <br />NICHOLAS LOEHRER <br />Active [ ] [ ] <br />2220 - SM HW GEN <5 TONSNR <br />PR0514019 <br />THREE VACANT3 <br />Active [ ] [ ] <br />2217 - APPLIANCE RECYCLER <br />PR0521482 <br />THUY TRAN <br />Inactive [ ] [ ] <br />2224 - HAZ MAT BUSINESS PLAN AUTHORIZATION <br />PR0512038 <br />HAZ MAT SJC OES <br />Inactive [ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />PR0509750 <br />HAZ MAT SJC OES <br />Inactive (] [ ] <br />2840 - AST EXEMPT FAC < 1,320 GAL <br />PR0535671 <br />STACY RIVERA <br />Inactive [ ] [ ] <br />4740 - WASTE TIRE SITE - EXEMPT <br />PR0523520 <br />AMANDA BOERTIEN <br />Inactive [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI <br />PRO533833 <br />not assigned <br />Inactive [ ] [ ] <br />