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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 5/8/2017 <br /> Submitted on: 5/3/2017 8:56:13AM CERS ID: 10182595 <br /> Submitted by: Jenell Bourassa Email: Jenell@hayesandson.com Facility ID in CERS: FA0009323 <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: 1 <br /> Owner ID OW0007323 <br /> Owner name DERRIEL R & ERIC R HAYES DERRIEL R & ERIC R HAYES 111 <br /> Mailing address 20177 S MACARTHUR DR 20177 S MACARTHUR DR 113 <br /> TRACY, CA 95304 TRACY, CA 95304 114, 115,116 <br /> Work phone 209-481-2657 209 481-2657 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009323 <br /> Facility name RALPH HAYES&SON INC RALPH HAYES &SON INC 3 <br /> Site address 20177 S MACARTHUR DR 20177 S MACARTHUR DR 103 <br /> City TRACY TRACY 104 <br /> ZIP code 95304 95304 105 <br /> Facility phone 209-835-4914 (209)835-4914 0 <br /> 102 <br /> Facility mailing address 20177 S MACARTHUR DR 20177 S MACARTHUR DR 108a <br /> TRACY, CA 95304 TRACY, CA 95304 108b 108c. 1084 <br /> BILLING INFORMATION <br /> Contact name Kim Armbruster Bambi Russel[ 140 <br /> Address 20177 S MACARTHUR DR 20177 S MACARTHUR DR 143 <br /> TRACY, CA 95304 TRACY, CA 95304 144, 145A46 <br /> 146 <br /> Contact phone 209-835-4914 209 835-4914 141 <br /> Contact email Kim@hayesandson.com Bambi@hayesandson.com 142 <br /> Mail invoices to Owner <br /> Program record [ ] HMBP SQG HW [ ] LQG HW [ ] RCRA HW New PR#: 1 S`il 19 <br /> created [ ) Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: 222o <br /> yAssigned to:Please bill: [ ] full calendar yearprorate this calendar year [ ] next calendar ear II y [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: VA Date: 5'S- '] <br /> --------------------------------------- --------- -- <br /> Accounting: Rev' ed by: 1,6 Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ Acct billed [ ] Surcharge verified By: Date: <br /> -------------- — -- ---- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 6 chem units PR0519548 NICHOLAS LOEHRER Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0524250 HARPRIT MATTU Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511611 TWO VACANT2 Inactive [ ] [ ) <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO509323 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO531977 not assigned Inactive [ ] [ ] <br /> t4W a qa-4-g <br />