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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Changes to EnvisionConnect by CERS Integration Wizard Date run: 8/17/2018 Submitted on: 2/13/2018 2:36:12PM CERS ID: 10745461 Submitted by: Wade Riddering Email: wade@erc-Ilc.us Facility ID in CERS: incorrect OWNER INFORMATION Owner ID Owner name Mailing address Work phone Information prior to CIW processing (current EC database) Number of Facilities for this Owner : 1 OW0022879 Rains, DAVID PO Box 3263 Crestline, CA 92325 909-714-2095 FACILITY FILE INFORMATION Facility ID FA0024337 Facility name Environmental & Chemical Consulting, Inc. Site address 9436 W Sugar Rd City Tracy ZIP code 95304 Facility phone 888-380-9664 Facility mailing address PO Box 3263 Crestline, CA 92325 BILLING INFORMATION Contact name David Rains Address PO Box 3263 Crestline, CA 92325 Contact phone 909-714-2095 Contact email david@eccinc.us Mail invoices to Account Information after CIW processing CERS (current submittal) field Rains 1 b/ lk, 111 PO Box 3263 113 Crestline, CA 92325 114, 115, 116 909-714-2095 112 Environmental & Chemical Consulting, Inc. 3 9436 W Sugar Rd 103 Tracy 104 95304 105 888-380-9664 102 PO Box 3263 108a Crestline, CA 92325 108b, 108c, 108d David Rains 140 PO Box 3263 143 Crestline, CA 92325 144, 145, 146 909-714-2095 141 david@eccinc.us 142 Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PR#: _ New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing Processed through CERS Integration Wizard by: A-1^011 Date: 0~1'—Y, Accounting: Reviewed by: 146 Date: 2 l Clerical: [ ] File [ ] Relabel file [ ] Create new file [ ] Acct billed [ ] Surcharge verified By: Date: ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Record ID Employee name Status Reactivated Inactivated 1921 - HMBP-Regular-Primary Location 5 chem units PR0542359 NICHOLAS LOEHRER Active I I I I