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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 8/2/2018 <br />Submitted on: 5/10/2018 1:37:32PM <br />CERS ID: 10740322 <br />Submitted by: James Yorke <br />Email: jryorke@yorkeengr.com <br />Facility <br />ID in CERS: incorrect <br />Information prior to CIW processing <br />Information after CIW processing CERS <br />OWNER INFORMATION <br />(current EC database) <br />(current submittal) field <br />Number of Facilities for this Owner: 1 <br />Owner ID <br />OW0003555 <br />Owner name <br />TRADER JOES #76 <br />Trader Joe's Company <br />111 <br />Mailing address <br />PO BOX 8000 <br />800 S. Shamrock Ave. <br />113 <br />MONSEY, NY 10952 <br />Monrovia, CA 91016 <br />114, 115, 116 <br />Work phone <br />209-951-7597 <br />(626) 599-3700 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0004664 <br />Facility name <br />TRADER JOES #76 <br />Trader Joe's #76 <br />3 <br />Site address <br />6535 PACIFIC AVE <br />6535 Pacific Ave <br />103 <br />City <br />STOCKTON <br />Stockton <br />104 <br />ZIP code <br />95207 <br />95207 <br />105 <br />Facility phone <br />209-951-7597 <br />(209) 951-7597 <br />102 <br />Facility mailing address <br />PO BOX 8000 <br />800 S. Shamrock Ave. <br />108a <br />MONSEY, NY 10952 <br />Monrovia, CA 91016 <br />108b, t0ac, 10sd <br />BILLING INFORMATION <br />Contact name <br />TRADER JOES #76 <br />Trader Joe's Company <br />140 <br />Address <br />PO BOX 8000 <br />800 S. Shamrock Ave. <br />143 <br />MONSEY, NY 10952 <br />Monrovia, CA 91016 <br />144, 145, 146 <br />Contact phone <br />Not Specified <br />(626) 599-3700 <br />141 <br />Contact email <br />invoices@traderjoes.com <br />142 <br />Mail invoices to <br />Facility <br />Program record [Vf HMBP [ ] SQG HW [ ] LQG HW <br />[ ] RCRA HW New PR#: <br />ZJ5-1361(6 <br />created [ ] Tiered permit [ ] APSA [ ] CalARP <br />[ ] UST New PE: 1c1ll <br />Assigned to: <br />Please bill: [ ] full <br />calendar year [ ] prorate calendar year [ ]] next calendar year [ <br />] exempt from billing <br />/this <br />(�:?-- <br />y-I_S <br />Processed through CERS Integration Wizard b <br />Date: <br />Accounting: Rev wed by:� Date: <br />Acct billed Surcharge <br />Clerical: [ ] File [ ] Relabel <br />By: <br />file [ ] Create new file <br />Date: <br />[ r] <br />[ ] verified( <br />?iv03(,vzlq ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status <br />1617 - RETAIL MARKET > 1000 SQ FT W / FOOD PREP PR0500169 VIDAL PEDRAZA Active <br />Reactivated Inactivated <br />