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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 8/12/2015 <br /> Submitted on: 7/21/2015 11:21:59AM CERS ID: 10637269 <br /> Submitted by: Sukhraj Sandhu Email: getsukhraj@yahoo.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 /> Owner ID OW0014770 <br /> Owner name SINGH, GURPARTAP Subway 62325 INC. 111 <br /> Mailing address 1135 PALOMAR CT 7503 W. Eleventh St 113 <br /> TRACY, CA 95377 Tracy, CA 95304 114, 115, 116 <br /> Work phone 209-321-5656 2098336400 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0022974 <br /> Facility name SUBWAY 62325 INC Subway 62325 INC 3 <br /> Site address 7503 W ELEVENTH ST 7503 W 11th St 103 <br /> City TRACY Tracy 104 <br /> ZIP code 95304 95304 105 <br /> Facility phone 209-321-5656 2098336400 102 <br /> Facility mailing address 1135 PALOMAR CT 7503 W. Eleventh St 108a <br /> TRACY, CA 95377 Tracy, CA 95304 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name SUBWAY 62325 INC Subway 62325 Inc. 140 <br /> Address 1135 PALOMAR CT 7503 W. Eleventh St 143 <br /> TRACY, CA 95377 Tracy, CA 95304 144, 145, 146 <br /> Contact phone 209-321-5656 2098336400 141 <br /> Contact email getsukhraj@yahoo.com 142 <br /> Mail invoices to Fa lity /j,. <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: V� Date: Q,-11--1 <br /> ------g. -----y--- --------------- <br /> Accountin Reviewed by: �1u Date: g�13I/� Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> Achill #ied- By: Date: <br /> ------------------ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1623-RESTAURANT/BAR 1-20 SEATS PR0540186 MELISSA NISSINA Active [ ] [ <br /> 1921 -HMBP-Regular-Primary Location PR0540223 MICHAEL PARISSI Active [ ] [ ] <br />