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SAN JOAQU OUNTY ENVIRONMENTAL HEALTAII&PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/24/2014 <br /> Submitted on: 1/6/2014 4:46:29PM CERS ID: 10182527 <br /> Submitted by: Chuck Schad Email: cschad@campora.com Facility ID in CERS: FA0009222 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) cur tsbmittal) field <br /> Owner ID OW0007222 <br /> Owner name TP CAMPORA/RON CAMPORA (209-941-8883 <br /> M CAMPORA 111 <br /> Mailing address PO BOX 31625 BOX 31717 113 <br /> STOCKTON, CA 95213 OCKTON, CA 95213 114, 115, 116 <br /> Work phone 209-941-8525 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009222 <br /> Facility name CAMPORA PROPANE SERVICE CAMPORA PROPANE SERVICE 3 <br /> Site address 2525 E MARIPOSA RD 2525 E MARIPOSA RD 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 952057820 95205-7820 105 <br /> Facility phone 209-466-8611 (209)466-8611 102 <br /> Facility mailing address PO BOX 31625 PO BOX 31625 108a <br /> STOCKTON. CA 95213 STOCKTON, CA 95213 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name CAMPORA PROPANE SERVICE CHUCK SCHAD 140 <br /> Address PO BOX 31625 PO BOX 31625 143 <br /> STOCKTON, CA 95213 STOCKTON, CA 95213 144. 145, 146 <br /> Contact phone Not Specified 209-466-8611 141 <br /> Contact email cschad@campora.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] 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 [ ] 1next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: kx'' Date: <br /> Accounting: Reviewed by: — Date: -�� Clerical: File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge 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 /> 1921 -HMBP-Regular-Primary Location PR051 4476 HAZA SAEED Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0513710 STACY RIVERA Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO509222 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2832-AST FAC 10 K-</=100 K GAL CUMULATIVE PR0523162 STACY RIVERA Inactive [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO527982 ALFONSO ARAMBULA Active <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534016 not assigned Inactive [ I [ ] <br />