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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 4/17/2017 <br /> Submitted on: 4/3/2017 11:52:11AM CERS ID: 10182333 <br /> Submitted by: Karina Romero Email: kromero@3ecompany.com Facility ID in CERS: FA0008046 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 14 <br /> Owner ID OW0001014 <br /> Owner name Walgreen Co. Walgreen Co. 111 <br /> Mailing address 200 Wilmot Rd 200 Wilmot Road 113 <br /> Deerfield, IL 60015 Deerfield, IL 60015 114, 115, 116 <br /> Work phone 847-914-2264 (847) 914-2264 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0008046 <br /> Facility name WALGREENS#02770 WALGREENS#02770 3 <br /> Site address 7929 LOWER SACRAMENTO RD 7929 LOWER SACRAMENTO RD 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95210 95210 105 <br /> Facility phone 209-474-0880 (209)474-0880 102 <br /> Facility mailing address 3207 Grey Hawk Court, Suite 200 3E Company, Reg.Dept. /Walgreen Co., 320 108a <br /> Carlsbad, CA 92010 Carlsbad, CA 92010 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name WALGREENS#02770 3E Company, Regulatory Dept/Walgreen Co 140 <br /> Address 3207 Grey Hawk Court, Suite 200 3207 Grey Hawk Court, Suite 200 143 <br /> Carlsbad, CA 92010 Carlsbad, CA 92010 144, 145, 146 <br /> Contact phone Not Specified (760) 602-8700 141 <br /> Contact email regulatory@3ecompany.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] 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 calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: /,/ori+ Ems— Date: <br /> ----- ------------ <br /> Accounting: Reviewed by: b6 Date: l Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 1 chem units PR0538630 JAMIE LIMA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0535451 VICKI MCCARTNEY Active [ ] [ ] <br /> 4557-MED WASTE LIMITED HAULER PR0536048 ROBERT MCCLELLON Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0536010 not assigned Inactive [ ] [ ] <br />