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SAN JOAQUIrCOUNTY ENVIRONMENTAL HEALTh4EPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 2/9/2015 <br /> Submitted on: 1/15/2015 1:40:20PM CERS ID: 10181895 <br /> Submitted by: Harry Shuler Email: paragonventures@sbcglobal.net Facility ID in CERS: FA0005616 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0004441 <br /> Owner name PARAGON VENTURES INC PARAGON VENTURES INC 111 <br /> Mailing address PO BOX 1170 PO BOX 2030 113 <br /> LSTOCKTON, CA 95201 STOCKTON, CA 95201 114,115,116 <br /> Work phone 09-466-3530 2094663530 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0005616 <br /> Facility name PARAGON VENTURES INC PARAGON VENTURES INC 3 <br /> Site address 1722 E FLORA ST 1722 E FLORA ST 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-466-3530 2094663530 102 <br /> Facility mailing address PO BOX 1170 PO BOX 2030 108a <br /> STOCKTON, CA 95201 STOCKTON, CA 95201 108b,108C,mad <br /> BILLING INFORMATION <br /> Contact name PARAGON VENTURES INC PARAGON VENTURES INC 140 <br /> Address PO BOX 1170 PO BOX 2030 143 <br /> STOCKTON, CA 95201 STOCKTON, CA 95201 144, 145, 146 <br /> Contact phone 209-466-3530 2094663530 141 <br /> Contact email ���� � Pk '/ paragonventures@sbcglobal.net 142 <br /> Mail invoices to (o*" <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRAHW 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: 1)5 Date: ' "A – 115 <br /> -------------------------------------------------- <br /> Accounting: Reviewed by: "Zwt Date: j0 1 — Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PR0520291 HAZA SAEED Active [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0502921 LETITIA BRIGGS Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510391 HAZ MAT SJC DES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO533837 not assigned Inactive [ ] [ ] <br />