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SANJOA OUNTY ENVIRONMENTAL HEALTHAPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 8/14/2014 <br /> Submitted on: 5/19/2014 11:52:53AM CERS ID: 10440307 <br /> Submitted by: Janelle Brown Email:jbrown@kendallcompliance.com Facility ID in CERS: FA0003183 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0010964 <br /> Owner name 99 CENTS ONLY STORES 99 Cents Only Stores 111 <br /> Mailing address 4000 UNION PACIFIC AVE 4000 Union Pacific Avenue 114 11 116 <br /> 13 <br /> COMMERCE, CA 90023 Commerce, CA 90023 <br /> Work phone (323) 980-8145 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003183 <br /> Facility name 99 CENTS ONLY STORES#185 99 Cents Only Stores#185 103 <br /> Site address 1320 W 11TH ST 1320 W 11th St 104 <br /> City TRACY Tracy <br /> Zip code 95376 95376 105 <br /> Facility phone 209-839-9619 (209) 839-9619 102 <br /> Facility mailing address 4000 E UNION PACIFIC AVE 4000 Union Pacific Avenue 108a <br /> COMMERCE, CA 90023 Commerce, CA 90023 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name 99 CENTS ONLY STORES#185 Paul Dolby 140 <br /> Address 4000 E UNION PACIFIC AVE 4000 Union Pacific Avenue 1aa 1as31a6 <br /> COMMERCE, CA 90023 Commerce, CA 90023 <br /> Contact phone 209-839-9619 (323) 980-8145 ext 1987 141 <br /> Contact email aul.Dolby@99only.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: P q{L�SS 1 <br /> Please bill: 'K full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: W1 Date: q•L`t' V1 — — <br /> ------------- <br /> Accounting: Reviewed by: _Date: Clerical: I Xile [ ] Relabel file <br /> new file <br /> [ Acct billed 1–j–St�rsgar9 By: Date_ <br /> i4�77- ------------------------------------- ----- <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 SQ FT (PREPKGD/LTD PREP) PRO161629 MELISSA NISSIM Active I 1 I 1 <br /> 2220-SM HW GEN<5 TONS/YR PR0538450 MICHELLE HENRY Active I 1 I 1 <br />