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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 8/15/2018 <br />Submitted on: 2/14/2018 3:25:09PM CERS ID: 10187311 <br />Submitted by: Stephen scheuerman Email: steve.scheuerman@xpo.com Facility ID in CERS: FA0019686 <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 />OW0016143 <br />NORBERT-DENTRESSANGLE <br />PO BOX 224 <br />DES MOINES, IA 50325 <br />209-833-5240 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0019686 <br />Facility name <br />NORBERT-DENTRESSANGLE <br />Site address <br />1565 N MACARTHUR DR STE 1 <br />City <br />TRACY <br />ZIP code <br />95376 <br />Facility phone <br />209-833-5240 <br />Facility mailing address 1565 N MACARTHUR DR STE 1 <br />TRACY, CA 95376 <br />BILLING INFORMATION <br />Contact name <br />Address <br />Contact phone <br />Contact email <br />Mail invoices to <br />NORBERT-DENTRESSANGLE <br />PO BOX 224 <br />DES MOINES, IA 50325 <br />Not Specified <br />mark.crashell@jacobsonco.com <br />Account <br />Information after CIW processing CERS <br />(current submittal) field <br />NORBERT-DENTRESSANGLE 111 <br />1565 N MACARTHUR DR STE 1 113 <br />TRACY, CA 95376 114, 115, 116 <br />209-833-5240 112 <br />NORBERT-DENTRESSANGLE 3 <br />1565 N MACARTHUR DR STE 1 103 <br />TRACY 104 <br />95376 105 <br />(209) 833-5240 102 <br />1565 N MACARTHUR DR STE 1 108a <br />TRACY, CA 95376 108b, 108c, 108d <br />NORBERT-DENTRESSANGLE 140 <br />1565 N MACARTHUR DR STE 1 143 <br />TRACY, CA 95376 144, 145, 146 <br />209-833-5240 141 <br />steve.scheuerman@xpo.com 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />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: 0" Date: <br />Accounting: Reviewed by: Date: �'(� ° Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified 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 4 chem units PR0529849 NICHOLAS LOEHRER Active [ ] [ ] <br />4740 - WASTE TIRE SITE - EXEMPT PRO530134 BENJAMIN ESCOTTO Inactive [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0533662 not assigned Inactive <br />