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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 4/6/2018 <br />Submitted on: 12/13/2017 9:41:39AM <br />Submitted by: Catherine Binczak Email: cbinczak@lumberliquidators.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: 1 <br />OW0021372 <br />Lumber Liquidators, Inc. <br />3000 John Deere Rd <br />Toano, VA 23168 <br />757-946-0087 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0023224 <br />Facility name <br />Lumber Liquidators Store 1358 <br />Site address <br />963 W March Ln <br />City <br />Stockton <br />ZIP code <br />95207 <br />Facility phone <br />209-337-3704 <br />Facility mailing address <br />3000 John Deere Rd <br />3000 John Deere Rd <br />Toano, VA 23168 <br />BILLING INFORMATION <br />114, 115, 116 <br />Contact name <br />Catherine Hoffman <br />Address <br />3000 John Deere Rd <br />Toano, VA 23168 <br />Contact phone <br />757-946-0087 <br />Contact email <br />choffman@lumberliquidators.com <br />Mail invoices to <br />Account <br />CERS ID: 10651183 <br />Facility ID in CERS: FA0023224 <br />Information after CIW processing CERS <br />(current submittal) field <br />Lumber Liquidators, Inc. <br />111 <br />3000 John Deere Rd <br />113 <br />Toano, VA 23168 <br />114, 115, 116 <br />7579460087 <br />112 <br />Lumber Liquidators Store 1358 3 <br />963 W March Ln 103 <br />Stockton 104 <br />95207 105 <br />2093373704 102 <br />3000 John Deere Rd 108a <br />Toano, VA 23168 108b, 108c, 108d <br />Catherine Binczak 140 <br />3000 John Deere Rd 143 <br />Toano, VA 23168 144, 145, 146 <br />7579460087 141 <br />cbinczak@lumberliquidators.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: Date: y <br />Accounting: Reviewed by: _IAl Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reac iv to nacti ed <br />1921 - HMBP-Regular-Primary Location 1 chem units PR0540605 JAMIE LIMA Inactive <br />�',l 0W �-µH `r! <br />