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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/15/2014 <br /> Submitted on: 12/10/2014 4:03:42PM CERS ID: 10187017 <br /> Submitted by: Eva Graw Email:joessmogshack@yahoo.com <br /> Facility ID in CERS: FA0018972 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0015609 <br /> Owner name JOSEPH R GRAW JOSEPH R GRAW 111 <br /> Mailing address PO BOX 1194 PO BOX 1194 113 <br /> TRACY, CA 95378 TRACY, CA 95378 114, 115, 11E <br /> Work phone 209-814-4766 209-814-4766 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0018972 <br /> Facility name JOES SMOG SHACK&AUTO JOES SMOG SHACK INC. 3 <br /> Site address 500 E TENTH ST UNIT E 500 E TENTH ST UNIT E 103 <br /> City TRACY 104 <br /> ZIP code 95376 95376 105 <br /> Facility phone 209-836-4766 (209) 836-4766 0 <br /> 102 <br /> Facility mailing address PO BOX 1194 TRACY PO BOX 1194 108a <br /> TRACY, CA 95378 TRACY, CA 95378 108b,108c,10E <br /> BILLING INFORMATION <br /> Contact name JOES SMOG SHACK&AUTO JOES SMOG SHACK INC. 140 <br /> Address PO BOX 1194 PO BOX 1194 143 <br /> TRACY, CA 95378 TRACY, CA 95378 144, 145, 14( <br /> Contact phone Not Specified 209-836-4766 141 <br /> Contact email joessmogshack@yahoo.com 142 <br /> Mail invoices to GwneF f) 1/1 <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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: !7i T Date: 1 <br /> Accounting: Reviewed by: Date: Clerical: [ ] File ( ] Relabel file [ ] Create new file <br /> [ ] Ac ed [ ] Surch— enfied By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1920-HMBP-Common Materials PR0528002 MICHAEL PARISSI Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PRO538544 THUY TRAN Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532415 not assigned Inactive [ ] [ ] <br />