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SAN JOAQUI'n.000NTY ENVIRONMENTAL HEALTH%mPEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 3/11/2015 <br /> Submitted on: 1/12/2015 5:18:38PM CERS ID: 10185857 <br /> Submitted by: Jim Pellegri Email:jimpellegr]@velociter.net Facility ID in CERS: FA0017077 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0013918 <br /> Owner name DAN PELLEGRI & SON INC DAN PELLEGRI & SON INC 111 <br /> Mailing address 9653 E WATERLOO RD 9653 E WATERLOO RD 113 <br /> STOCKTON, CA 952159208 STOCKTON, CA 95215-9208 114, 115,116 <br /> Work phone (209) 481-0062 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017077 <br /> Facility name DAN PELLEGRI & SON INC DAN PELLEGRI &SON INC 3 <br /> Site address 5704 N ALPINE RD 5704 N ALPINE RD 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95215 95215 105 <br /> Facility phone 209-481-0062 (209)481-0062 0 <br /> 102 <br /> Facility mailing address 9653 E WATERLOO RD 9653 E WATERLOO RD 108a <br /> STOCKTON, CA 952159208 STOCKTON, CA 95215-9208 108b,1080,108d <br /> BILLING INFORMATION <br /> Contact name DAN PELLEGRI &SON INC DAN PELLEGRI & SON INC 140 <br /> Address 226 E LANCASTER DR 226 E LANCASTER DR 143 <br /> STOCKTON, CA 95207 STOCKTON, CA 95207 144, 145, 146 <br /> Contact phone Not Specified (209)481-0062 141 <br /> Contact email142 <br /> Mail invoices to Gvpwr- A V/ <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST 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: 19yr`^ Date: <br /> -------------------------------------------------- <br /> Accounting: Reviewed by: �< Date: 3tl 15-- Clerical: [ ] 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 Reactivated Inactivated <br /> 1958-HM-Farm Operations _ PRQ525262 HAZA SAEED Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PRO528971 FATINAH ZAREEF Active [ ] Pr <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO531630 not assigned Inactive [ ] [ ] <br /> I J <br />