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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 4/28/2016 <br />Submitted on: 4/12/2016 1:47:42PM <br />Submitted by: Casey Haynes Email: casey@haynesbrothersinc.com <br />CERS ID: 10614823 <br />Facility ID in CERS: FA0022737 <br />[ ] RCRA HW New PR#: <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 />Assigned to: <br />Number of Facilities for this Owner : 1 <br />Please bill: {. `] full calendar year <br />Owner ID <br />OW0020507 <br />(calendar <br />Processed through CERS Integration Wizard by: w' `' <br />Date: <br />Owner name <br />Haynes Brothers Investments LLC <br />Haynes Brothers Investments LLC <br />111 <br />Mailing address <br />1533 S. Stockton St <br />1533 S. Stockton St <br />113 <br />[ ] Create new file <br />Lodi, CA 95240 <br />Lodi, CA 95240 <br />114, 115, 116 <br />Work phone <br />209-369-0644 <br />2093690644 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0022737 <br />Facility name <br />PACIFIC TOWING <br />PACIFIC TOWING <br />3 <br />Site address <br />1533 S STOCKTON ST STE B <br />1533 S STOCKTON ST STE B <br />103 <br />City <br />LODI <br />LODI <br />104 <br />ZIP code <br />95240 <br />95240 <br />105 <br />Facility phone <br />209-369-0644 <br />2093690644 <br />102 <br />Facility mailing address <br />1533 south stockton st <br />1533 south stockton st <br />108a <br />lodi, CA 95240 <br />lodi, CA 95240 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name <br />PACIFIC TOWING <br />Casey Haynes <br />140 <br />Address <br />1533 south stockton st STE B <br />1533 south stockton st <br />143 <br />lodi, CA 95240 <br />lodi, CA 95240 <br />144, 145, 146 <br />Contact phone <br />209-369-0644 <br />2093690644 <br />141 <br />Contact email <br />casey@haynesinvestments.com <br />casey@haynesinvestments.com <br />142 <br />Mail invoices to <br />Account <br />Program record HMBP [ ] <br />SQG HW [ ] LQG HW <br />[ ] RCRA HW New PR#: <br />VA -0 S � 0�— <br />created [ ] Tiered permit [ ] <br />APSA [ ] CaIARP <br />[ ] UST 4 -New PE: <br />1 01 1? -1 <br />Assigned to: <br />L A <br />Please bill: {. `] full calendar year <br />[ ] prorate` this year [ ] next calendar year [ <br />] exempt from billing <br />(calendar <br />Processed through CERS Integration Wizard by: w' `' <br />Date: <br />V' <br />513/ <br />Accounting: Reviewed by: <br />Date: <br />Clerical: [ ] File [ ] Relabel file <br />[ ] Create new file <br />l(1 Acct billed [ <br />____________By:_____ <br />Date_ <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name Status <br />2220 - SM HW GEN <5 TONSNR PR0539740 ARIS VELOSO Active <br />C2 (,Ih�� <br />Reactivated Inactivated <br />