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SAN JOAQUIN'tOUNTY ENVIRONMENTAL HEALTHTVEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/20/2014 <br /> Submitted on: 3/4/2013 9:26:53AM CERS ID: 10180849 <br /> Submitted by: Kristal Helfrich Email: kristal@raymerbusiness.com Facility ID in CERS: FA0002006 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0009994 <br /> Owner name WOMAR INC WOMAR INC 111 <br /> Mailing address 2643 3RD ST 2643 3RD ST 113 <br /> LIVERMORE, CA 94550 LIVERMORE, CA 94550 114, 115, 116 <br /> Work phone 925-292-1024 9252921024 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0002006 <br /> Facility name CARLS JR#495/7485 CARLS JR#495/7485 3 <br /> Site address 2610 W MARCH LN 2610 W MARCH LN 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95207 95207 105 <br /> Facility phone 209-957-7311 (209) 957-7311 102 <br /> Facility mailing address 2643 3RD ST 2643 3RD ST 108a <br /> LIVERMORE, CA 94550 LIVERMORE, CA 94550 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name CARLS JR#495/7485 KRISTAL HELFRICH 140 <br /> Address 2643 3RD ST 2643 3RD ST 143 <br /> LIVERMORE, CA 94550 LIVERMORE, CA 94550 144, 145, 146 <br /> Contact phone Not Specified 9252921024 141 <br /> Contact email KRISTAL@RAYMERBUSINESS.COM 142 <br /> Mail invoices to Facility �/ <br /> Program 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: 11 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Ac I ed [ ] ��Lrh verified By: Date <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> /1625-RESTAURANT/BAR 51-100 SEATS PRO160484 MARIBEL FLOHRSCHUTZ Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PRO521096 LOWELL ALLEN Active I ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0511078 HAZ MAT SJC DES Inactive [ ] [ ] <br />