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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 1/26/2016 <br />Submitted on: 1/21/2016 2:32:53PM <br />Submitted by: John Hernandez Email: jhernandez@hollandco.com <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner: 1 <br />OW0021433 <br />HOLLAND LP <br />1000 HOLLAND DR <br />CRETE, IL 60417 <br />FACILITY FILE INFORMATION <br />CERS ID: 10654681 <br />Facility ID in CERS: incorrect <br />Information after CIW processing CERS <br />(current submittal) field <br />Holland LP 111 <br />2201 W. Washington St. Box 1 Compartm 113 <br />Stockton, CA 95203 114, 115, 116 <br />708-672-2410 112 <br />Facility ID FA0023257 <br />l/r✓ Date: <br />Clerical: [ <br />Facility name HOLLAND LP <br />Holland LP <br />3 <br />Site address 1201 RAILROAD WAY <br />1201 Railroad Way <br />103 <br />City STOCKTON <br />Stockton <br />104 <br />ZIP code 95203 <br />95203 <br />105 <br />Facility phone 209-986-6363 <br />209-467-1445 <br />102 <br />Facility mailing address 1000 HOLLAND DR <br />1201 Railroad Way <br />108a <br />CRETE, IL 60417 <br />Stockton, CA 95203 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name HOLLAND LP <br />Holland LP <br />140 <br />Address 1000 HOLLAND DR <br />1000 Holland Drive <br />143 <br />CRETE, IL 60417 <br />Crete, IL 60417 <br />144, 145, 146 <br />Contact phone Not Specified <br />708-672-2317 <br />141 <br />Contact email <br />Jhernandez@hollandco.com <br />142 <br />Mail invoices to F �Ity <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ <br />] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ <br />] UST New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year <br />[ ] next calendar year [ <br />] exempt from billing <br />Processed through CERS Integration Wizard by: lam"' Date: ( - � k to <br />Accounting: Reviewed by: <br />l/r✓ Date: <br />Clerical: [ <br />] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed <br />[ ] Surcharge verified <br />By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING <br />THROUGH CIW <br />Pro ram Element and Description <br />Record ID <br />Employee name <br />Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location <br />PRO540676 <br />ROBERT LOPEZ <br />Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR <br />PRO540677 <br />STACY RIVERA <br />Active 11 [ ] <br />