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SAN JOAQUIN-COUNTY ENVIRONMENTAL HEALTFPTlEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 8/14/2014 <br /> Submitted on: 8/30/2013 1:45:21PM CERS ID: 10454884 <br /> Submitted by: Crystalyn Alford Email: calford@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 3207 GREY HAWK CT STE 200 200 Wilmot Road 113 <br /> CARLSBAD, CA 92010 Deerfield, IL 60015 114, 115,115 <br /> Work phone (847) 914-2264 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0021338 <br /> Facility name WALGREENS#09723 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 847-527-4439 (209)476-8819 102 <br /> Facility mailing address 3207 GREY HAWK CT STE 200 3E Company, Regulatory Dept/Walgreen, 32 108a <br /> CARLSBAD, CA 92010 Carlsbad, CA 92010 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name WALGREENS#09723 3E Company, Regulatory Dept/Walgreens 140 <br /> Address 3207 GREY HAWK CT STE 200 3207 Grey Hawk Court, Suite 200 143 <br /> CARLSBAD, CA 92010 Carlsbad, CA 92010 144, 145,145 <br /> Contact phone Not Specified (760)602-8700 141 <br /> Contact email regulatory@3ecompany.com 142 <br /> Mail invoices to Facility <br /> Program record HMBP [ ] SQG HW [ ] LOG HW [ ] RCRA HW New PR#: S`�iq 3`K1 <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: tel?,I <br /> Assigned to: SAle� <br /> Please bill: X] full Calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: \AJ Date: 4R'•�4.L j <br /> Accounting: Reviewed by: Date: Clerical: File [ ] Relabel file Create new file <br /> --- <br /> Acct billed By: Date_ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 2220-SM HW GEN<5 TONS/YR PR0538448 MICHELLE HENRY Active I I I I <br /> CA,I �' . 2l LL+e-O .S <br />