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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11/24/2014 <br /> Submitted on: 11/18/2014 9:54:44AM CERS ID: 10182329 <br /> Submitted by: Kris Stuebner Email: kstuebner@jemmanagement.com Facility ID in CERS: FA0008023 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0006626 <br /> Owner name The Wendy's Company Desmond Foods LP 111 <br /> Mailing address 312 W CROMWELL AVE 312 W. Cromwell Ave 113 <br /> FRESNO, CA 93711 Fresno, CA 93711 114, 115, 11E <br /> Work phone 614-764-3400 559-135-9648 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0008023 <br /> Facility name WENDYS INTERNATIONAL#2659 Wendy's 3 <br /> Site address 3810 E HAMMER LN 3810 E Hammer Ln 103 <br /> City STOCKTON Stockton 104 <br /> ZIP code 95212 95212 105 <br /> Facility phone 209-952-0333 559-650-7835 102 <br /> Facility mailing address 312 W CROMWELL AVE 3810 E Hammer Ln 108a <br /> FRESNO, CA 93711 Stockton, CA 95212 108b,mac,toe <br /> BILLING INFORMATION <br /> Contact name WENDYS INTERNATIONAL#2659 Accounts Payable 140 <br /> Address 312 W CROMWELL AVE 312 W. Cromwell Ave. 143 <br /> FRESNO, CA 93711 Fresno, CA 93711 144, 145, 14( <br /> Contact phone Not Specified 559-435-9648 141 <br /> Contact email kstuebner@jemmanagement.com 142 <br /> Mail invoices to Fac lity %✓ <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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: ;r 5 Date: 11 12t9 I I`I <br /> Accounting: Reviewed by: ki Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Aced ( ] Surchar erifiec / By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1625-RESTAURANTIBAR 51-100 SEATS PRO508257 STEPHANIE RAMIREZ Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PR0520985 HAZA SAEED Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO517648 RAYMOND BORGES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533594 not assigned Inactive [ ] [ ] <br />