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BILLING
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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1403
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1900 - Hazardous Materials Program
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PR0519640
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BILLING
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Entry Properties
Last modified
9/6/2018 9:55:45 AM
Creation date
6/9/2018 1:32:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
BILLING
RECORD_ID
PR0519640
PE
1921
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
01
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
EJimenez
Supplemental fields
FilePath
\MIGRATIONS\C\COUNTRY CLUB\1403\PR0519640\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
7/19/2017 6:41:14 PM
QuestysRecordID
3518920
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 5/31/2017 <br />Submitted on: 5/31/2017 12:36:55PM <br />Submitted by: Tom Robins Email: Tom.Robins@unitedpacific.com <br />CERS ID: 10182103 <br />Facility ID in CERS: FA0006438 <br />Facility name <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 />Facility phone <br />Number of Facilities for this Owner: <br />Contact phone <br />Not Specified <br />Owner ID <br />OW0011808 <br />Mail invoices to <br />Account <br />Owner name <br />AFRO LLC <br />AFRO LLC <br />111 <br />Mailing address <br />4130 Cover Street <br />4130 Cover Street <br />113 <br />Active <br />Long Beach, CA 90808 <br />Long Beach, CA 90808 <br />114, 115, 116 <br />Work phone <br />310-323-3992 <br />310-323-3992 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0006438 <br />Facility name <br />UNITED # 5446 <br />Site address <br />1403 W COUNTRY CLUB BLVD <br />City <br />STOCKTON <br />ZIP code <br />95204 <br />Facility phone <br />310-323-3992 <br />Facility mailing address <br />4130 Cover Street <br />1403 W COUNTRY CLUB BLVD <br />Long Beach, CA 90808 <br />BILLING INFORMATION <br />104 <br />Contact name <br />UNITED # 5446 <br />Address <br />4130 Cover Street <br />Long Beach, CA 90808 <br />Contact phone <br />Not Specified <br />Contact email <br />By: <br />Mail invoices to <br />Account <br />United # 5446 <br />3 <br />1403 W COUNTRY CLUB BLVD <br />103 <br />STOCKTON <br />104 <br />95204 <br />105 <br />310-323-3992 <br />102 <br />4130 Cover Street 108a <br />Long Beach, CA 90808 108b, 108c, 1084 <br />MICHAEL SANCHEZ <br />140 <br />4130 Cover Street <br />143 <br />Long Beach, CA 90808 <br />144 145, 146 <br />310-323-3992 <br />141 <br />PERMITS@UNITEDPACIFIC.COM <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST <br />New PRM _ <br />New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] <br />next calendar year [ <br />] exempt from billing <br />an C:?-- 5-51-13 <br />Processed through CERS Integration Wizard by: Date: <br />Accounting: Reviewed by: � Date: W101-1 Clerical: <br />[ ] File [ ] Relabel <br />file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified <br />By: <br />Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name <br />Status <br />Reactivated Inactivated <br />V921 - HMBP-Regular-Primary Location 18 chem units PR0519640 ROBERT LOPEZ <br />Active <br />[ ] [ ] <br />2220 - SM HW GEN <5 TONSNR PR0521815✓ STACY RIVERA <br />Active <br />[ ] [ ] <br />2361 - UST FACILITY PR0231995✓ STACY RIVERA <br />Active <br />[ ] [ ] <br />2224 - HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511744 HAZ MAT SJC OES <br />Inactive <br />[ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0507627 MICHAEL KITH <br />Inactive <br />[ ] [ ] <br />2950 -ENVIRON ASSESS PR0505513 MICHAEL INFURNA <br />Inactive <br />[ ] [ ] <br />3123 - STORMWATER INSPECTION - RETAIL GAS OUTLET PR0523000 GARRETT BACKUS <br />Inactive <br />[ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PRO534473 not assigned <br />Inactive <br />[ ] [ ] <br />
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