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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 1/25/2016 <br />Submitted on: 1/15/2016 6:25:54AM CERS ID: 10185165 <br />Submitted by: Sheila Caballero Email: sheila.caballero@shawgrp.com Facility ID in CERS: FA0016413 <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 />OW0013286 <br />Lowe's Home Centers, LLC <br />101 Andover Park E Ste 200 c/o Mailcode A; <br />Tukwila, WA 98188 <br />206-242-8570 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0016413 <br />Facility name <br />LOWE'S #1706 <br />Site address <br />1389 S LOWER SACRAMENTO RD <br />City <br />LODI <br />ZIP code <br />95242 <br />Facility phone <br />888-429-6281 <br />Facility mailing address 1000 LOWE'S BLVD <br />MOORESVILLE, NC 28117 <br />BILLING INFORMATION <br />Contact name Rob Gass <br />Address 1000 LOWE'S BLVD. <br />MOORESVILLE, NC 28117 <br />Contact phone 704-758-6033 <br />Contact email Robert.A.Gass@lowes.com <br />Mail invoices to Account <br />Information after CIW processing CERS <br />(current submittal) field <br />Lowe's Home Centers, LLC 111 <br />101 Andover Park E Ste 200 c/o Mailcode A: 113 <br />Tukwila, WA 98188 114, 115, 116 <br />(206) 242-8570 112 <br />LOWE'S #1706 3 <br />1389 S LOWER SACRAMENTO RD 103 <br />LODI 104 <br />95242 105 <br />(888) 429-6281 102 <br />1000 LOWE'S BLVD 108a <br />MOORESVILLE, NC 28117 108b, 108c,108d <br />Rob Gass 140 <br />1000 LOWE'S BLVD. 143 <br />MOORESVILLE, NC 28117 144, 145, 146 <br />(704) 758-6033 141 <br />Robert.A.Gass@[owes.com 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: ? 0-o` L-� 0 - <br />created <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: V"/'' i Date: I ; � - (' I �-- <br />Accounting: Reviewed by: Date: t l(f Clerical: [ j File [ ] Relabel file [ ] Create new file <br />[ j Acct billed [ ] Surcharge verified By: Date: <br />-------------------------------------------------- <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />I.Program Element and Description Record ID Employee name Status Reactivated Inactivated <br />1-1921 - HMBP-Regular-Primary Location PR0524470 JAMIE DE LA ROSA Active [ ] [ ] <br />2220 - SM HW GEN <5 TONSNR PR0536647 MICHELLE HENRY Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PRO534483 not assigned Inactive [ ] [ ] <br />