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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 11/29/2017 <br /> Submitted on: 10/26/2017 1:51:26PM CERS ID: 10748761 <br /> Submitted by: Jack Scarsi Email:jack.scarsi@us-ac.com Facility ID in CERS: incorrect <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORM (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 1 <br /> Owner I OW0022924 <br /> me US Air Conditioning Distributors, LLC US Air Conditioning Distributors, LLC 111 <br /> Mailing address 16900 Chestnut Street 16900 Chestnut Street 113 <br /> City of Industry, CA 91748 City of Industry, CA 91748 114, 115, 116 <br /> Work phone 626-854-4507 626-854-4507 112 <br /> FACILITY FILE INFION <br /> acuity ID FA0024364 <br /> F cility na USAir Conditioning Distributors-Stockton E US Air Conditioning Distributors- Stockton Bra 3 <br /> SI ess 2455 Teepee Dr 2455 Teepee Dr 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-466-4153 209-466-4153 102 <br /> Facility mailing address 2455 Teepee Drive 2455 Teepee Drive 108a <br /> Stockton, CA 95205 Stockton, CA 95205 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name Jack Scarsi Jack Scarsi 140 <br /> Address 16900 Chestnut Street 16900 Chestnut Street 143 <br /> City of Industry, CA 91748 City of Industry, CA 91748 144, 145, 146 <br /> Contact phone 626-854-4507 626-854-4507 141 <br /> Contact email jack.scarsi@us-ac.com jack.scarsi@us-ac.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG 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: al^'1 � Date: 11� 1 ` �0 <br /> Accounting: R viewed by: t 11 <br /> _Date: 3D1( - Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> Acct billed [ ] Surcharge verified By: -Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> or Employee name Status Reactivated Inactivated <br /> 921/HMBP-Regular-Primary Location 9 chem units P554 2 ROBERT LOPEZ Active [ ] [ 1 <br /> Cre% S. �w � ►�,{ c [I'1\� l �� Px [ckl\ 05 (kr CF-9S hln►nr q` <br /> (il�v 3D3�3� <br /> d �� " <br />