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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1116f2014 <br /> Submitted on: 9/4/2014 9:58:59AM CERS 1D: 10454887 <br /> Submitted by: Karina Romero Email: kromero@3ecompany.com Facility ID in CERS: FA0021446 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0017599 <br /> Owner name Walgreen Co. Walgreen Co. 111 <br /> Mailing address 200 Wilmot Road 200 Wilmot Road 113 <br /> Deerfield, IL 60015 Deerfield, IL 60015 114, 115, 11E <br /> Work phone 847-914-2264 (847) 914-2264 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0021446 <br /> Facility name Walgreens#12549 Walgreens#12549 3 <br /> Site address 2040 E Mariposa Rd 2040 E Mariposa Rd 103 <br /> City Stockton Stockton 104 <br /> Zip code 95205 95205 105 <br /> Facility phone 209-465-4167 (209) 465-4167 102 <br /> Facility marling address 3207 GREY HAWK CT STE 200 3E Company, Regulatory Dept/Walgreen, 32 108a <br /> CARLSBAD, CA 92010 Carlsbad, CA 92010 108b, 108c,102 <br /> BILLING INFORMATION <br /> Contact name Walgreens #12549 3E Company, Regulatory Dept/Walgreens 140 <br /> Address 3207 GREY HAWK CT STE 200 3207 Grey Hawk Court, Suite 200 143 <br /> CARLSBAD, CA 92010 Carlsbad, CA 92010 144, 145, 14( <br /> Contact phone Not Specified (760) 602-8700 141 <br /> Contact email regulatory@3ecompany.com regulatory@3ecompany.com 142 <br /> Mail invoices to Facility f I J <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG 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: J Date: 1)////W Clerical: File <br /> ( ] [ ] Relabel file [ ] Create new file <br /> `[ ] A filled [ Surcy eritied By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW a <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PR0539382 ROBERT LOPEZ Active [ ] 1 <br /> 2220-SM HW GEN 45 TONS/YR PR0538446 MICHELLE HENRY Active I 1 <br />