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SAN JOAQUI OUNTY ENVIRONMENTAL HEALAEPARTMENT I W <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 718/2014 <br /> Submitted on: 1/28/2014 11:35:10AM CERS ID: 10401910 <br /> Submitted by: Carolyn Des Jardin Email: cdesjardin@3ecompany.com Facility ID in CERS: FA0018760 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> (current EC database) (current submittal) field <br /> OWNER INFORMATION <br /> Owner ID OW0015427 111 <br /> Owner name CSK AUTO INC CSK Auto, Inc. <br /> Mailing address 3207 GREY HAWK CT STE 200 702 E. Bethany Home Road 114,1 53116 <br /> CARLSBAD, CA 920106664 Phoenix, AZ 85014 112 <br /> Work phone 602-631-7203 (417) 862-3333 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0018760 <br /> Facility name O'REILLY AUTO PARTS#3810 5e1IW Main St Auto <br /> #3810 103 <br /> Site address 1551 W MAIN ST 104 <br /> City RIPON Ripon <br /> Zip code 95366 95366 105 <br /> Facility phone 209-599-1546 209-599-1546 102 <br /> Facility mailing address 3207 GREY HAWK CT STE 200 3E Company, Regulatory Dept./O'Reilly Autc 108a <br /> CARLSBAD, CA 920106664 Carlsbad, CA 92010 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name O'REILLY AUTO PARTS#3810 3E Company, Regulatory Dept./O'Reilly Autc 140 <br /> Address 3207 GREY HAWK CT STE 200 3207 Grey Hawk Court, Suite 200 144 143las <br /> CARLSBAD, CA 92010-6664 Carlsbad, CA 92010 141 <br /> Contact phone Not Specified 760-602-8700 <br /> Contact emailregulatory@3ecompany.com 142 <br /> E/ProO�Mail invoices to AE--- <br /> Program <br /> gram record [ ] HMBP [ ] SOG 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: Date: <br /> Accounting: Reviewed by: _—Date: F Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Ac lied [ ] Surchrg� Ifie By: Date: <br /> --- --------- —————————- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PR0527676 MICHAEL PARISSI Active I 1 I 1 <br /> 2220-SM HW GEN<5 TONS/YR PRO535769 MICHELLE HENRY Active I 1 1 1 <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE F PR0534045 not assigned Inactive I 1 [ 1 <br />