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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 5/4/2018 <br /> Submitted on: 1/3/2018 9:19:25AM CERS ID: 10184527 <br /> Submitted by: David Ray Email: specializedtruck@yahoo.com Facility ID in CERS: FA0013801 <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 OW0009598 <br /> Owner name RAY, DAVID David Ray 111 <br /> Mailing address PO BOX 8403 5520 Kermit Lane 113 <br /> STOCKTON, CA 95208 Stockton, CA 95207 114, 115, 116 <br /> Work phone 209-462-5078 (209) 933-1150 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0013801 <br /> Facility name SPECIALIZED TRUCK SERVICE Specialized Truck Service 3 <br /> Site address 19681 N HWY 99 19681 N HWY 99 103 <br /> City ACAMPO ACAMPO 104 <br /> ZIP code 95220-9799 95220-9799 105 <br /> Facility phone 209-462-5078 (209) 462-5078 102 <br /> Facility mailing address PO BOX 8403 PO Box 1030 108a <br /> STOCKTON, CA 95208 Lodi, CA 95241 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name SPECIALIZED TRUCK SERVICE David Ray 140 <br /> Address PO BOX 8403 PO Box1030 143 <br /> STOCKTON, CA 95208 Lodi, CA 95241 144, 145, 146 <br /> Contact phone 209-462-5078 (209)462-5078 141 <br /> Contact email specializedtruck@yahoo.com speclallzedtruck@yahoo.com 142 <br /> Mail invoices to Account <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 [ ] next calendarear <br /> n /� y [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: ✓�'� aL, Date: <br /> --------------- <br /> Accounting: Reviewed by: � Date:5ro /4 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 /> Record ID Emolovee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 5 chem units PR0521176 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0528498 AARON HANG Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO518272 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0518273 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 2840-AST EXEMPT FAC <1,320 GAL PRO528457 AARON HANG Inactive [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO524446 Garrett Alias-Backus Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0532848 not assigned Inactive [ ] [ ] <br />