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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 4/9/2015 <br /> Submitted on: 2/13/2015 6:33:39AM CERS ID: 10600843 <br /> Submitted by: Joe Mark Email: jmark2@ufpi.com Facility ID in CERS: FA0009531 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0007531 <br /> Owner name UFP Thornton LLC UFP Thornton LLC 111 <br /> Mailing address 26200 Nowell Rd 2801 East Beltline NE 113 <br /> Thornton, CA 95686 Grand Rapids, MI 49525 114. 115, 116 <br /> Work phone 209-456-2190 616-365-1526 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009531 <br /> Facility name UFP Thornton LLC UFP Thornton LLC 3 <br /> Site address 26200 Nowell Rd 26200 Nowell Rd 103 <br /> City Thornton Thornton 104 <br /> ZIP code 95686 95686 105 <br /> Facility phone 209-456-2190 209-456-2190 102 <br /> Facility mailing address 26200 Nowell Rd. 26200 Nowell Rd. 108a <br /> Thornton, CA 95686 Thornton, CA 95686 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name Jay Berry Robert Dickens 140 <br /> Address 26200 Nowell Rd 2801 East Beltline NE 143 <br /> Thornton, CA 95686 Grand Rapids, MI 49525 144, 145, 146 <br /> Contact phone 209-456-2190 616-365-1526 141 <br /> Contact email jberry@ufpi.c m rdickens@ufpi.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 calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: 051,-1 Date: [4-11— ty <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 PR0519309 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO513888 ARIS VELOSO Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO527998 BENJAMIN ESCOTTO Active [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1184)-obsolete PR0503803 FATINAH ZAREEF Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509531 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534597 not assigned Inactive [ ] [ ] <br />