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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/11/2017 <br /> Submitted on: 1/6/2017 7:38:45AM CERS ID: 10140597 <br /> Submitted by: James Tunney Email:james.tunney@searshc.com <br /> Facility ID in CERS: FA0003278 <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: 2 <br /> Owner ID OW0002315 <br /> Owner name Kmart Corporation Kmart Corporation 111 <br /> Mailing address 3333 Beverly Road, B5-348A 3333 Beverly Road, B5-348A 113 <br /> Hoffman Estates, IL 60179 Hoffman Estates, IL 60179 114, 115, 116 <br /> Work phone 847-286-3667 847-286-3667 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003278 <br /> Facility name Kmart#3174 Kmart#3174 3 <br /> Site address 2180 E Mariposa Rd 2180 E Mariposa Rd 103 <br /> City Stockton Stockton 104 <br /> 95205 <br /> ZIP code 95205 <br /> Facility phone 209-948-8205 95205105 <br /> 8-8205 <br /> 102 <br /> Facility mailing address 3333 Beverly Road, 135-348A 3333 Beverly Road, B5-348A 108a <br /> Hoffman Estates, IL 60179 Hoffman Estates, IL 60179 108b,108c,lo8d <br /> BILLING INFORMATION <br /> Contact name Cynthia Miller James Tunney 140 <br /> Address 3333 Beverly Road, 65-348A 3333 Beverly Road, B5-348A 143 <br /> Hoffman Estates, IL 60179 Hoffman Estates, IL 60179 144, 145. 146 <br /> Contact phone 847-286-7994 847-286-3667 141 <br /> Contact email Cynthia.Miller@searshc.com james.tunney@searshc.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ I SQG 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: A71171WU M Date: 1111 /1-7 <br /> Accounting: Reviewed by: _ Date: 1112-11 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified <br /> By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1614-FOOD EST>1001 SO FT W/O SEATING PRO161524 LEYNA HUYNH Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location i chem units PRO520022 HAZA SAEED Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO531067 PAULINE MANGRAI Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512300 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PRO502273 LETITIA BRIGGS Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510012 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523647 HARPRIT MATTU Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO534064 not assigned Inactive [ ] [ ] <br />