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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: 5/12/2017 3:27:59PM CERS, ID: 10734973 <br />Submitted by: Jose Arias Email: jose_arias@shepardbros.com Facility ID in CERS: FA0015645 <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 : 1 <br />OW0016861 <br />Shepard Bros. Inc. <br />503 S. Cypress St <br />La Habra, CA 90631 <br />562-697-1366 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0015645 <br />Facility name <br />Shepard Bros. - Stockton <br />Site address <br />4407 Giannecchini Ln <br />City <br />Stockton <br />ZIP code <br />95206 <br />Facility phone <br />562-697-1366 <br />Facility mailing address 4407 Giannechini Ln. <br />Stockton, CA 95206 <br />BILLING INFORMATION <br />Contact name Jose Arias <br />Address 503 S. Cypress St <br />La Habra, CA 90631 <br />Contact phone 562-697-1366 <br />Contact email jose_arias@shepardbros.com <br />Mail invoices to Account <br />Information after CIW processing CERS <br />(current submittal) field <br />Shepard Bros. Inc. 111 <br />503 S. Cypress St 113 <br />La Habra, CA 90631 114, 115, 116 <br />562-697-1366 112 <br />Shepard Bros. - Stockton 3 <br />4407 Giannecchini Ln 103 <br />Stockton 104 <br />95206 105 <br />562-697-1366 102 <br />4407 Giannechini Ln. 108a <br />Stockton, CA 95206 108b, 108c, 108d <br />Jose Arias 140 <br />503 S. Cypress St 143 <br />La Habra, CA 90631 144, 145, 146 <br />562-697-1366 141 <br />jose_arias@shepardbros.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: 00 vvk V— Date: 5—t)--7 <br />---------------------------------------------- <br />Accounting: Reviewed by: V�> Date: f5ll 9j I Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />Acct billed ]Surcharge verified_ _ — — Date_ <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactiv ttd Inactivated <br />1921 - HMBP-Regular-Primary Location 1 chem units PR0523312 ROBERT LOPEZ Inactive [ [ ] <br />2218 - CRT HANDLER PR0523175 STACY RIVERA Inactive [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0523174 STACY RIVERA Inactive [ ] [ ] <br />&<< L,- 3D C,�C, . 4 " O�7--- <br />W 11 A /1> <br />