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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 5/11/2017 <br />Submitted on: 5/5/2017 6:41:01 PM CERS ID: 10711549 <br />Submitted by: Helen Yeh Email: helen.yeh@pandarg.com Facility ID in CERS: incorrect <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner : £1 <br />OW0011593 <br />Panda Restaurant Group, Inc. <br />1683 Walnut Grove Ave. <br />Rosemead, CA 91770 <br />626-799-9898 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0023175 <br />Facility name <br />PANDA EXPRESS #2513 <br />Site address <br />1572 E FREMONT ST <br />City <br />STOCKTON <br />ZIP code <br />95202 <br />Facility phone <br />209-937-9896 <br />Facility mailing address 1572 E FREMONT ST <br />Information after CIW processing CERS <br />(current submittal) field <br />Panda Restaurant Group, Inc. 111 <br />1683 Walnut Grove Avenue 113 <br />Rosemead, CA 91770 114, 115, 116 <br />(626) 799-9898 112 <br />Panda Express #2513 3 <br />1572 E. Fremont St. 103 <br />Stockton 104 <br />95202 105 <br />(209) 937-9896 102 <br />Panda Restaurant Group, Tax Accounting, 1 108a <br />Rosemead, CA 91770 108b, 108c, 108d <br />Panda Restaurant Group, Inc. #2513 140 <br />1683 Walnut Grove Ave. 143 <br />Rosemead, CA 91770 144, 145, 146 <br />(626) 799-9898 141 <br />helen.yeh@pandarg.com 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />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: Date: <br />Accounting: Reviewed by: f 4, Date: 6�114ol / � Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactivated Inactivated <br />1624 - RESTAURANT/BAR 21-50 SEATS PR0540530 LEYNA HUYNH Active [ ] [ ] <br />1919 - HMBP-0O2 Only Food Facility 1 chem units PR0541771 JEFFREY WONG Active [ ] [ ] <br />STOCKTON, CA 95202 <br />BILLING INFORMATION <br />Contact name <br />PANDA EXPRESS #2513 <br />Address <br />1572 E FREMONT ST <br />STOCKTON, CA 95202 <br />Contact phone <br />209-937-9896 <br />Contact email <br />Mail invoices to <br />Facility <br />Information after CIW processing CERS <br />(current submittal) field <br />Panda Restaurant Group, Inc. 111 <br />1683 Walnut Grove Avenue 113 <br />Rosemead, CA 91770 114, 115, 116 <br />(626) 799-9898 112 <br />Panda Express #2513 3 <br />1572 E. Fremont St. 103 <br />Stockton 104 <br />95202 105 <br />(209) 937-9896 102 <br />Panda Restaurant Group, Tax Accounting, 1 108a <br />Rosemead, CA 91770 108b, 108c, 108d <br />Panda Restaurant Group, Inc. #2513 140 <br />1683 Walnut Grove Ave. 143 <br />Rosemead, CA 91770 144, 145, 146 <br />(626) 799-9898 141 <br />helen.yeh@pandarg.com 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />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: Date: <br />Accounting: Reviewed by: f 4, Date: 6�114ol / � Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactivated Inactivated <br />1624 - RESTAURANT/BAR 21-50 SEATS PR0540530 LEYNA HUYNH Active [ ] [ ] <br />1919 - HMBP-0O2 Only Food Facility 1 chem units PR0541771 JEFFREY WONG Active [ ] [ ] <br />