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SAN JOAQUi.. 000NTY ENVIRONMENTAL HEALTH. _,EPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 4/9/2015 <br />Submitted on: 1/27/2015 2:29:20PM <br />Submitted by: Karen Kern Email: karen.kern@hdsupply.com <br />FACILITY FILE INFORMATION <br />Facility ID <br />Information prior to CIW processing <br />OWNER INFORMATION <br />(current EC database) <br />Owner ID <br />OW0015100 <br />Owner name <br />HD SUPPLY INC <br />Mailing address <br />3100 CUMBERLAND BLVD STE 1700 <br />Facility phone <br />ATLANTA, GA 30339 <br />Work phone <br />770-852-9000 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0018381 <br />Facility name <br />HD SUPPLY BUILDER SOLUTIONS GROU <br />Site address <br />11928 HARLAN RD <br />City <br />LATHROP <br />ZIP code <br />95330 <br />Facility phone <br />209-461-6000 <br />Facility mailing address 3100 CUMBERLAND BLVD STE 1700 <br />ATLANTA, GA 30339 <br />BILLING INFORMATION <br />Contact name HD SUPPLY BUILDER SOLUTIONS GROU <br />Address 3100 CUMBERLAND BLVD STE 1700 <br />ATLANTA, GA 30339 <br />Contact phone Not Specified <br />Contact email <br />Mail invoices to Owner <br />CERS ID: 10615261 <br />Facility ID in CERS: incorrect <br />Information after CIW processing CERS <br />(current submittal) field <br />Creative Touch Interiors 111 <br />3100 Cumberland Blvd Ste 1700-MS1226 113 <br />Atlanta, GA 30339 114, 115, 116 <br />2156512960 112 <br />CREATIVE TOUCH INTERIORS 3 <br />11928 S Harlan Rd 103 <br />Lathrop 104 <br />95330 105 <br />(209)234-1008 102 <br />11928 S Harlan Road 108a <br />Lathrop, CA 95330 108b, 108c, 108d <br />Karen Kern 140 <br />3100 Cumberland Blvd Ste 1700-MS1226 143 <br />Atlanta, GA 30339 144, 145, 146 <br />(215)651-2960 141 <br />karen.kern@hdsupply.com 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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: W' ` Date: ' Cl10— <br />' t <br />Accounting: Reviewed by: v1-_' Date: ��L�'�l Clerical: N 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 Rea ti ated Inactivated <br />1921 - HMBP-Regular-Primary Location PR0527122 not assigned Inactive [ ] <br />►fit L.c. (� C N SOA 5 <br />