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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 11/17/2015 <br />Submitted on: 11/17/2015 7:21:08AM <br />Submitted by: Melanie Stanisic Email: mstanisic@darden.com <br />OWNER INFORMATION <br />Owner I D <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />OW0016228 <br />Darden Restaurants, Inc. <br />PO Box 695011 <br />Orlando, FL 32869-5011 <br />407-245-4000 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0014496 <br />Facility name <br />Olive Garden #1582 <br />Site address <br />3140 Naglee Rd <br />City <br />Tracy <br />ZIP code <br />95304 <br />Facility phone <br />209-835-9926 <br />Facility mailing address PO Box 695011 <br />Orlando, FL 32869-5011 <br />BILLING INFORMATION <br />Contact name <br />OLIVE GARDEN #1582 <br />Address <br />PO Box 695011 <br />Tracy <br />Orlando, FL 32869-5011 <br />Contact phone <br />407-245-4000 <br />Contact email <br />rhayward@darden.com <br />Mail invoices to <br />Account <br />CERS ID: 10184695 <br />Facility ID in CERS: FA0014496 <br />Information after CIW processing CERS <br />(current submittal) field <br />Darden Restaurants, Inc. 111 <br />PO Box 695011 113 <br />Orlando, FL 32869-5011 114, 115, 116 <br />407-245-4000 112 <br />Olive Garden #1582 <br />3 <br />3140 Naglee Rd <br />103 <br />Tracy <br />104 <br />95304 <br />105 <br />209-835-9926 <br />102 <br />PO Box 695011 108a <br />Orlando, FL 32869-5011 108b, 108c, 10sd <br />Darden Licensing Department 140 <br />PO Box 695011 143 <br />Orlando, FL 32869-5011 144, 145, 146 <br />407-245-4000 141 <br />rhayward@darden.com 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: <br />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: IS <br />-------------------------------------------------- <br />Accounting: Reviewed by: b'5 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 />1626 - RESTAURANT/BAR 101 + SEATS PR0521326 MELISSA NISSIM Active [ ] [ ] <br />1921 - HMBP-Regular-Primary Location PRO526531 PETER LOMBARDI Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532666 not assigned Inactive [ ] [ ] <br />