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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 4/2/2015 <br /> Submitted on: 3/20/2015 11:46:12AM CERS ID: 10183683 <br /> Submitted by: ALEX TERRILL Email: aterrill@terrilltrans.com Facility ID in CERS: FA0010621 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008621 <br /> Owner name TERRILL, KEVIN S TERRILL, KEVIN S 111 <br /> Mailing address 2459 MARIPOSA RD 2459 MARIPOSA RD 113 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 114, 115, 116 <br /> Work phone 209-931-5410 2094623322 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010621 <br /> Facility name TERRILL TRANSPORTATION TERRILL TRANSPORTATION 3 <br /> Site address 2459 MARIPOSA RD 2459 MARIPOSA RD 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-462-3322 (209)462-3322 102 <br /> Facility mailing address 1213 MOFFAT BLVD 2459 MARIPOSA RD 108a <br /> MANTECA, CA 95336 STOCKTON, CA 95205 108b, 1080,108d <br /> BILLING INFORMATION <br /> Contact name TERRILL TRANSPORTATIONTERRILL TRANSPORTATION 140 <br /> Address 1213 MOFFAT BLVD I/ 1213 moffatt blvd 143 <br /> MANTECA, CA 95336 manteca, CA 95336 144, 145, 146 <br /> Contact phone Not Specified 2092392145 141 <br /> Contact email142 <br /> Mail invoices to ili <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> v'Y <br /> Processed through CERS Integration Wizard by: VDate: <br /> Accounting: Reviewed by: 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 /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PRO520817 HAZA SAEED Active [ ] ( ] <br /> 2227-GEN 5<25 TONS PERMIT PR0514388 STACY RIVERA Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0524084 BENJAMIN ESCOTTO Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510621 HAZ MAT SJC DES Inactive [ ] ( ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532383 not assigned Inactive [ ] [ ] <br />