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SAN JOAQUI OUNTY ENVIRONMENTAL HEALT PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 712/2014 <br /> Submitted on: 2/6/2013 5:44:41PM CERS ID: 10184165 <br /> Submitted by: rajvir kaur Email: rajvir@att.net Facility ID in CERS: FA0012197 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0014830 <br /> Owner name KAUR, RAJVIR KAUR, RAJVIR 111 <br /> Mailing address 9266 WHITEWATER LN 3622 poolo circle 113 <br /> STOCKTON, CA 95219 STOCKTON, CA 95212 114, 115, 116 <br /> Work phone 209-951-2524 209-405-3555 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0012197 <br /> Facility name SUBWAY/TCBY SUBWAY/TCBY 3 <br /> Site address 5308 PACIFIC AVE STE 92 5308 PACIFIC AVE STE 92 103 <br /> City STOCKTON STOCKTON 104 <br /> ,Zip code 95207 95207 105 <br /> Facility phone 209-951-2527 (209) 951-2527 102 <br /> Facility mailing address 5308 PACIFIC AVE#92 5308 PACIFIC AVE#92 108a <br /> STOCKTON, CA 95207 STOCKTON, CA 95207 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name SUBWAY/TCBY SUBWAY/TCBY 140 <br /> Address 5308 PACIFIC AVE#92 5308 PACIFIC AVE#92 143 <br /> STOCKTON, CA 95207 STOCKTON, CA 95207 144, 145, 146 <br /> Contact phone 209-951-2527 209-951-2524 141 <br /> Contact email 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 [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: <br /> Accounting: Reviewed by: Date: fJ ) Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> -F-}-Acotbtlttsd �{�-3vre[tiarg By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1613-FOOD EST 501-1000 SO FT W/O SEATING PR0515505 MARIBEL FLOHRSCHUTZ Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PR0530854 HAZA SAEED Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE F PR0533067 not assigned Inactive [ ] [ ] <br />