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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 8/24/2018 <br />Submitted on: 5/9/2018 12:29:23PM CERS ID: 10721335 <br />Submitted by: Osvaldo Gomez Email: ogomez@tigersul.com Facility ID in CERS: incorrect <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 />OW0022444 <br />Tiger -Sul <br />PO BOX 2089 <br />Stockton, CA 95201 <br />209-451-2725 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0023984 <br />Facility name <br />Tiger -Sul <br />Site address <br />65 Stork Rd <br />City <br />Stockton <br />ZIP code <br />95203 <br />Facility phone <br />209-451-2725 <br />Information after CIW processing <br />(current submittal) <br />Tiger -Sul <br />4 Armstrong Rd; Suite 220 <br />Shelton, CT 06484 <br />(209) 242-7602 <br />(� Tiger -Sul <br />61 Stork Rd <br />Stockton <br />(209) 242-7602 <br />Facility mailing address <br />PO BOX 2089 <br />Stockton, CA 95201 <br />BILLING INFORMATION <br />Contact name <br />Ozzie Gomez <br />Address <br />PO BOX 2089 <br />Stockton, CA 95201 <br />Contact phone <br />209-451-2725 <br />Contact email <br />ogomgez@tigersul.com <br />Mail invoices to <br />Account <br />61 Stork Rd. <br />Stockton, CA 95203 <br />Ozzie Gomez <br />61 Stork Rd. <br />Stockton, CA 95203 <br />(209) 242-7602 <br />ogomez@tigersul.com <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ j UST <br />New PR#: _ <br />New PE: <br />Assigned to: <br />CERS <br />field <br />111 <br />113 <br />114, 115, 116 <br />112 <br />3 <br />103 <br />104 <br />105 <br />102 <br />108a <br />108b, 108c, 108d <br />140 <br />143 <br />144, 145, 146 <br />141 <br />142 <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: ^i t2— Date: <br />Accounting: Reviewed by: U- Date:gI1 j9 ]V Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location 17 chem units PR0541826 ROBERT LOPEZ Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0541825 STACY RIVERA Active [ ] [ ] <br />LL,LK.In<f- up,n,ro�� ( e,�k L,��ez[ Heol C\as.( �h�� bb <br />