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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 11/2/2015 <br />Submitted on: 11/2/2015 7:21:OOAM CERS ID: 10140041 <br />Submitted by: Deborah Williams Email: deborah.j.williams@autozone.com Facility ID in CERS: FA0011243 <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 />Number of Facilities for this Owner : 1 <br />Owner ID <br />OW0009243 <br />Owner name <br />AutoZone Stores Inc <br />AutoZone Stores Inc <br />111 <br />Mailing address <br />123 South Front Street <br />123 South Front Street <br />113 <br />Memphis, TN 38103 <br />Memphis, TN 38103 <br />114, 115, 116 <br />Work phone <br />901-495-6500 <br />901-495-6500 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0011243 <br />Facility name <br />AutoZone #5684 <br />AutoZone #5684 <br />3 <br />Site address <br />1339 S Sutter St <br />1339 S Sutter St <br />103 <br />City <br />Stockton <br />Stockton <br />104 <br />ZIP code <br />95206 <br />95206 <br />105 <br />Facility phone <br />209-944-9254 <br />209-944-9254 <br />102 <br />Facility mailing address <br />Dept 8190, 123 South Front Street <br />Dept 8190, 123 South Front Street <br />108a <br />Memphis, TN 38103 <br />Memphis, TN 38103 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name <br />Bryan Blair <br />Deborah Williams <br />140 <br />Address <br />Dept 8190, 123 South Front Street <br />Dept 8190, 123 South Front Street <br />143 <br />Memphis, TN 38103 <br />Memphis, TN 38103 <br />144, 145, 146 <br />Contact phone <br />901-495-7217 <br />901-495-7129 <br />141 <br />Contact email <br />bryan.blair@autozone.com <br />deborah.j.williams@autozone.com <br />142 <br />Mail invoices to <br />Owp er <br />Program record [ ] HMBP <br />[ ] 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 [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: to V Date: <br />Accounting: Reviewed by: " Date: I ! `� 11 5- Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location PRO520774 ROBERT LOPEZ Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PRO519237 MICHELLE HENRY Active [ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0511243 HAZ MAT SJC OES Inactive [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PRO533039 not assigned Inactive [ ] [ ] <br />