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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 7/24/2017 <br /> Submitted on: 7/24/2017 12:09:07PM CERS ID: 10739470 <br /> Submitted by: DAVID STEVENS Email: david.stevens@odfl.com Facility ID in CERS: incorrect <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 OW0013169 <br /> Owner name OLD DOMINION FREIGHT LINE Old Dominion Freight Line 111 <br /> Mailing address 601 D ARCY PKWY 500 Old Dominion Way 113 <br /> LATHROP, CA 95330 Thomasville, NC 27360 114, 115,116 <br /> Work phone 336-889-5000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016281 <br /> Facility name OLD DOMINION FREIGHT LINE Old Dominion Freight Line -Stockton 3 <br /> Site address 601 D ARCY PKWY 601 Darcy Pkwy 103 <br /> City LATHROP Lathrop 104 <br /> ZIP code 95330 95330 105 <br /> Facility phone 209-858-5173 866-883-6335 102 <br /> Facility mailing address 601 D ARCY PKWY 601 D'ARCY PARKWAY 108a <br /> LATHROP, CA 95330 Lathrop, CA 95330 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name OLD DOMINION FREIGHT LINE Sam Faucette 140 <br /> Address 601 D ARCY PKWY 500 Old Dominion Way 143 <br /> LATHROP, CA 95330 Thomasville, INC 27360 144, 145, 146 <br /> Contact phone 209-858-5173 336-889-5000 141 <br /> Contact email sam.faucette@odfl.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW 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: QW'O\ N Date: <br /> ------------- ------------------ <br /> Accounting: Re iewed by: Date: ��� 17 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> ----- [ Acct billed [ ] Surcharge verified By: — Date: <br /> CTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 4740-WASTE TIRE SITE-EXEMPT PR0524262 BENJAMIN ESCOTTO Active [ ]/ [ ] <br /> 1921 -HMBP-Regular-Primary Location 1 chem units PR0524484 NICHOLAS LOEHRER Inactive <br /> 2220-SM HW GEN<5 TONSNR PR0528650✓ TWO VACANT2 Inactive [vr [ ] <br /> 2840-AST EXEMPT FAC < 1,320 GAL PRO528649 THUY TRAN Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533147 not assigned Inactive [ ] [ ] <br /> PQ,CZ95 5r�,. +.�. 3'I�� (kV 2 a,ell, OD 1� <br /> " 2'16/ -7 <br />