Laserfiche WebLink
SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/14/2017 <br />Submitted on: 6/13/2017 3:18:30PM CERS ID: 10187165 <br />Submitted by: Scott Montgomery Email: smontgomery@clarkpest.com Facility ID in CERS: FA0019285 <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner: 1 <br />OW0015827 <br />Joe Clark <br />555 North Guild Avenue <br />Lodi, CA 95240 <br />209-368-7152 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0019285 <br />Facility name <br />CLARK PEST CONTROL INC <br />Site address <br />4827 Clowes Rd <br />City <br />STOCKTON <br />ZIP code <br />95210 <br />Facility phone <br />209-474-3204 <br />Facility mailing address <br />4816 Clowes Street <br />Stockton, CA 95210 <br />BILLING INFORMATION <br />Contact name <br />Dave Shewmake <br />Address <br />4816 Clowes Street <br />Stockton, CA 95210 <br />Contact phone <br />209-474-3204 <br />Contact email <br />dshewmake@clarkpest.com <br />Mail invoices to <br />Account <br />Information after CIW processing CERS <br />(current submittal) field <br />Joe Clark 111 <br />555 North Guild Avenue 113 <br />Lodi, CA 95240 114, 115, 116 <br />(209)368-7152 112 <br />CLARK PEST CONTROL INC <br />3 <br />4827 CLOWES RD <br />103 <br />STOCKTON <br />104 <br />95210 <br />105 <br />(209) 474-3204 <br />102 <br />4816 Clowes Street <br />108a <br />Stockton, CA 95210 <br />108b, 108c, 108d <br />Tony Garcia <br />140 <br />4816 Clowes Street <br />143 <br />Stockton, CA 95210 <br />144, 145, 146 <br />(209)474-3204 <br />141 <br />tgarcia@clarkpest.com <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ j RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />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: Date: &- I H-17 <br />----------------- <br />Accounting: Reviewed by: 66 Date:041—ip -I Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ I Acct billed [ ] Surcharge verified By: Date: <br />-------------------------- <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location 5 chem units PR0528722 JAMIE LIMA Active [ ] [ ] <br />2220 - SM HW GEN <5 TONSNR PR0539204/ VICKI MCCARTNEY Active [ ] [ ] <br />4740 - WASTE TIRE SITE - EXEMPT PR0540192 HARPRIT MATTU Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0534151 not assigned Inactive [ ] [ ] <br />