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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 11/6/2015 <br />Submitted on: 11/4/2015 12:31:31PM <br />Submitted by: Deborah Williams Email: deborah.j.williams@autozone.com <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner : 5 <br />OW0008924 <br />AutoZone Stores Inc <br />123 South Front Street <br />MEMPHIS, TN 38103 <br />901495-6500 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0010924 <br />Facility name <br />AutoZone #2858 <br />Site address <br />1100 N WILSON WAY <br />City <br />STOCKTON <br />ZIP code <br />95205 <br />Facility phone <br />209-942-2992 <br />Facility mailing address Dept 8190, 123 South Front Street <br />Memphis, TN 38103 <br />BILLING INFORMATION <br />Contact name Bryan Blair <br />Address Dept 8190, 123 South Front Street <br />Memphis, TN 38103 <br />Contact phone 901-495-7217 <br />Contact email bryblair@autozone.com <br />Mail invoices to F ility A <br />CERS ID: 10140027 <br />Facility ID in CERS: FA0010924 <br />Information after CIW processing CERS <br />(current submittal) field <br />AutoZone Stores Inc 111 <br />123 South Front Street 113 <br />Memphis, TN 38103 114, 115, 116 <br />901-495-6500 112 <br />AutoZone #2858 <br />3 <br />1100 N Wilson Way <br />103 <br />Stockton <br />104 <br />95205 <br />105 <br />209-942-2992 <br />102 <br />Dept 8190, 123 South Front Street 108a <br />Memphis, TN 38103 108b, 108c, 108d <br />Deborah Williams 140 <br />Dept 8190, 123 South Front Street 143 <br />Memphis, TN 38103 144, 145, 146 <br />901-495-7129 141 <br />deborah.j.williams@autozone.com 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: <br />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: (I- (O � 11 <br />------------------------------------------------ <br />Accounting: Reviewed by: l6 Date: I I '1IS Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />-------------------------------------------------- <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 PR0520552 HAZA SAEED Active [ ] [ ] <br />2220 - SM HW GEN <5 TONSNR PR0514453 MICHELLE HENRY Active [ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510924 HAZ MAT SJC OES Inactive [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532441 not assigned Inactive [ ] [ ] <br />