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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11/6/2014 <br /> Submitted on: 9/2/2014 12:32:49PM CERS ID: 10454884 <br /> Submitted by: Karina Romero Email: kromero@3ecompany.com Facility ID in CERS: FA0021338 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0017599 <br /> Owner name Walgreen Co. Walgreen Co. 111 <br /> Mailing address 200 Wilmot Road 200 Wilmot Road 113 <br /> Deerfield, IL 60015 Deerfield, IL 60015 114, 115, 11E <br /> Work phone 847-914-2264 (847) 914-2264 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0021338 <br /> Facility name Walgreens#9723 Walgreens#9723 3 <br /> Site address 3131 W Hammer Ln 3131 W Hammer Ln 103 <br /> City Stockton Stockton 104 <br /> Zip code 95209 95209 105 <br /> Facility phone 209-476-8819 (209) 476-8819 102 <br /> Facility mailing address 3207GREY HAWK CT STE 200 3E Company, Regulatory Dept/Walgreen, 3� 108a <br /> CARLSBAD, CA 92010 Carlsbad, CA 92010 108b,108c,10E <br /> BILLING INFORMATION <br /> Contact name Walgreens#9723 3E Company, Regulatory Dept/Walgreens 140 <br /> Address 3207GREY HAWK CT STE 200 3207 Grey Hawk Court, Suite 200 143 <br /> CARLSBAD, CA 92010 Carlsbad, CA 92010 144, 145, 14( <br /> Contact phone Not Specified (760) 602-8700 141 <br /> Contact email regulatory@3ecompany.com regulatory@3ecompany.com 142 <br /> Mail invoices to Feeilityr /// <br /> Program record [ J HMBP [ ] SQG HW [ J LOG 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 calendarear <br /> nt y [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: <br /> Accounting: Reviewed by: Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acgt-billed [ ] Surchailed 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 PRO539381 HAZA SAEED Active [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0538448 MICHELLE HENRY Active [ ] [ ] <br />