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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 11/9/2015 <br />Submitted on: 11/9/2015 7:54:26AM <br />Submitted by: Noelle Taylor Email: ntaylor@riteaid.com <br />CERS ID: 10186893 <br />Facility ID in CERS: FA0018556 <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: 14 <br />Owner ID <br />OW0000686 <br />Owner name <br />THRIFTY PAYLESS, INC <br />THRIFTY PAYLESS, INC <br />111 <br />Mailing address <br />30 Hunter Lane <br />30 Hunter Lane <br />113 <br />Camp Hill, PA 17011 <br />Camp Hill, PA 17011 <br />114, 115, 116 <br />Work phone <br />717-761-2633 <br />717-761-2633 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0018556 <br />Facility name <br />RITE AID #6490 <br />RITE AID #6490 <br />3 <br />Site address <br />599 E VALPICO RD <br />599 E VALPICO RD <br />103 <br />City <br />TRACY <br />TRACY <br />104 <br />ZIP code <br />95376-9100 <br />95376-9100 <br />105 <br />Facility phone <br />209-830-0976 <br />(209) 830-0976 <br />102 <br />Facility mailing address <br />30 Hunter Lane, Attn EH&S <br />30 Hunter Lane, Attn EH&S <br />108a <br />Camp Hill, PA 17011 <br />Camp Hill, PA 17011 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name <br />Rite Aid Corporation, Attn EH&S <br />Rite Aid Corporation, Attn EH&S <br />140 <br />Address <br />30 Hunter Lane <br />30 Hunter Lane <br />143 <br />Camp Hill, PA 17011 <br />Camp Hill, PA 17011 <br />144, 145. 146 <br />Contact phone <br />717-975-8643 <br />717-975-8643 <br />141 <br />Contact email <br />rsksafe@riteaid.com <br />ehs@riteaid.com <br />142 <br />Mail invoices to <br />Account <br />Program record HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: ��S`'C o 5 1 t <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: jc�l 2 - <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year If -;next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: Date: <br />------------------------— <br />Accounting: Reviewed by: � Date: // 1111 S_. 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 />1617 - RETAIL MARKET > 1000 SQ FT W / FOOD PREP PR0527406 MELISSA NISSIM Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0536066 MICHELLE HENRY Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0536067 not assigned Inactive [ ] [ ] <br />