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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 6/15/2017 <br />Submitted on: 6/14/2017 2:28:26PM <br />Submitted by: Sharlene Woods Email: sharlene@bggroupinc.com <br />CERS ID: 10063345 <br />Facility ID in CERS: FA0015977 <br />Processed CERS Integration Wizard by: Date: <br />Information prior to CIW processing <br />Information after CIW processing <br />CERS <br />OWNER INFORMATION <br />(current EC database) <br />(current submittal) <br />field <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Number of Facilities for this Owner : 1 <br />Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location 2 chem units PR0530825 NICHOLAS LOEHRER <br />Owner ID <br />OW0012901 <br />Active [ ] [ ] <br />2351 - UST FACILITY - 2481 COMPLIANT PR0523684✓ TWO VACANT2 <br />Owner name <br />Fast Lane Central Valley LLC <br />Fast Lane Central Valley LLC <br />111 <br />Mailing address <br />111 Healdsburg Ave <br />2005 Stagecoach Rd., Ste 200 <br />113 <br />Healdsburg, CA 95448 <br />Santa Rosa, CA 95404 <br />114, 115, 116 <br />Work phone <br />707-326-0369 <br />7074313510 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0015977 <br />Facility name <br />Fast Lane Central Valley <br />Fast Lane Central Valley <br />3 <br />Site address <br />116 Roth Rd <br />116 Roth Rd <br />103 <br />City <br />Lathrop <br />Lathrop <br />104 <br />ZIP code <br />95330 <br />95330 <br />105 <br />Facility phone <br />707-431-3510 <br />7074313510 <br />102 <br />Facility mailing address <br />111 Healdsburg Ave, Ste C <br />2005 Stagecoach Rd., Ste. 200 <br />108a <br />Healdsburg, CA 95448 <br />Santa Rosa, CA 95404 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name <br />Christina Gill <br />Christina Gill <br />140 <br />Address <br />2005 STAGECOACH RD STE 200 <br />2005 Stagecoach Rd., Ste 200 <br />143 <br />SANTA ROSA, CA 95404 <br />Santa Rosa, CA 95404 <br />144, 145, 146 <br />Contact phone <br />707-431-3510 <br />7074313510 <br />141 <br />Contact email <br />chgill@bggroupinc.com <br />chgill@bggroupinc.com <br />142 <br />Mail invoices to <br />Account <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW <br />[ ] RCRA HW New PR#: <br />created [ ] Tiered <br />permit [ ] APSA [ ] CalARP <br />[ ] UST New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] <br />next calendar year [ ] exempt from billing <br />Processed CERS Integration Wizard by: Date: <br />through <br />Accounting: Reviewed by: Date: I (/ 1, Clerical: <br />[ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified <br />By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name <br />Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location 2 chem units PR0530825 NICHOLAS LOEHRER <br />Active [ ] [ ] <br />2220 - SM HW GEN <5 TONSNR PR0527093 TWO VACANT2 <br />Active [ ] [ ] <br />2351 - UST FACILITY - 2481 COMPLIANT PR0523684✓ TWO VACANT2 <br />Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532244 not assigned <br />Inactive [ ] [ ] <br />