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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 12/8/2015 <br />Submitted on: 12/7/2015 2:04:12PM <br />CERS ID: 10180609 <br />Submitted by: Manu Trehan <br />Email: manutrehan@hotmail.com <br />Facility ID in CERS: <br />FA0000511 <br />800 E KETTLEMAN LN <br />Information prior to CIW processing <br />Information after CIW pr cessing <br />CERS <br />OWNER INFORMATION(current <br />EC database) <br />(current submittal) <br />field <br />Mail invoices to <br />Number of Facilities for this Owner: 1 <br />Owner ID <br />OW0000422 <br />Owner name <br />TREHAN, PROMOD K <br />TREHAN, PROMOD K <br />111 <br />Mailing address <br />10203 TANK HOUSE DR <br />10203 TANK HOUSE DR <br />113 <br />STOCKTON, CA 95209 <br />STOCKTON, CA 95209 <br />114, 115, 116 <br />Work phone <br />209-334-3678 <br />(209) 334-3678 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0000511 <br />Facility name <br />AJS AM/PM MINI MARKET <br />Site address <br />800 E KETTLEMAN LN <br />City <br />LODI <br />ZIP code <br />95240 <br />Facility phone <br />209-334-3678 <br />Facility mailing address 800 E KETTLEMAN LN <br />AJS AM/PM MINI MARKET 3 <br />800 E KETTLEMAN LN 103 <br />LODI 104 <br />95240 105 <br />(209) 334-3678 102 <br />800 E KETTLEMAN LN 108a <br />LODI, CA 95240 108b, 108c, 108d <br />AJS AM/PM MINI MARKET 140 <br />800 E KETTLEMAN LN 143 <br />LODI, CA 95240 144, 145, 146 <br />(209) 334-3678 141 <br />MANUTREHAN@HOTMAIL.C,OM 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG 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 calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: `/VfQ Date: <br />Accounting: Reviewed by: bl'5 Date: �Z�y 15 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 />1617 - RETAIL MARKET > 1000 SQ FT W / FOOD PREP PRO161886 JEFFREY WONG Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0534921 ARIS VELOSO Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0534922 not assigned Inactive [ ] [ ] <br />LODI, CA 95240 <br />BILLING INFORMATION <br />Contact name <br />AJS AM/PM MINI MARKET <br />Address <br />800 E KETTLEMAN LN <br />LODI, CA 95240 <br />Contact phone <br />209-334-3678 <br />Contact email <br />Mail invoices to <br />Facility <br />AJS AM/PM MINI MARKET 3 <br />800 E KETTLEMAN LN 103 <br />LODI 104 <br />95240 105 <br />(209) 334-3678 102 <br />800 E KETTLEMAN LN 108a <br />LODI, CA 95240 108b, 108c, 108d <br />AJS AM/PM MINI MARKET 140 <br />800 E KETTLEMAN LN 143 <br />LODI, CA 95240 144, 145, 146 <br />(209) 334-3678 141 <br />MANUTREHAN@HOTMAIL.C,OM 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG 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 calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: `/VfQ Date: <br />Accounting: Reviewed by: bl'5 Date: �Z�y 15 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 />1617 - RETAIL MARKET > 1000 SQ FT W / FOOD PREP PRO161886 JEFFREY WONG Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0534921 ARIS VELOSO Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0534922 not assigned Inactive [ ] [ ] <br />