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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 5/12/2017 <br /> Submitted on: 5/10/2017 7:30:28AM CERS ID: 10187507 <br /> Submitted by: Janice Oldemeyer Email:joldemeyer@myoer.com Facility ID in CERS: FA0020091 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 3 <br /> Owner ID OW0015056 <br /> Owner name Janice Oldemeyer& Ronald Kemp Janice Oldemeyer& Ronald Kemp 111 <br /> Mailing address 2331 Teepee Drive 2331 Teepee Drive 113 <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 114, 115, 116 <br /> Work phone 209-234-7994 (209) 234-7994 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0020091 <br /> Facility name ONSITE ELECTRONICS RECYCLING ONSITE ELECTRONICS RECYCLING 3 <br /> Site address 2331 N TEEPEE DR 2331 N TEEPEE DR 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-234-7994 (209) 234-7994 102 <br /> Facility mailing address PO BOX 655 2331 Teepee Drive 108a <br /> CLEMENTS, CA 95227 Stockton, CA 95205 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name ONSITE ELECTRONICS RECYCLING ONSITE ELECTRONICS RECYCLING 140 <br /> Address 2331 Teepee Drive 2331 Teepee Drive 143 <br /> Stockton, CA 95205 Stockton, CA 95205 144, 145, 146 <br /> Contact phone 209-234-7994 (209) 234-7994 141 <br /> Contact email 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] 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: Date: <br /> Accounting: Reviewed by:—ttl> Date: 5I17I 1 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> urchar a 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 8 chem units PRO531215 ROBERT LOPEZ Active [ ] [ ] <br /> 2217-APPLIANCE RECYCLER PRO531199 THREE VACANT3 Active [ ] [ ] <br /> 2218-CRT HANDLER PR0531200 THREE VACANT3 Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0531198 THREE VACANT3 Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531868 not assigned Inactive [ ] [ ] <br />