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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 7/11/2017 <br /> Submitted on: 7/10/2017 5:15:55PM CERS ID: 10184481 <br /> Submitted by: STEINHART STEINHART Email: steinhart4@sbcglobal.net Facility ID in CERS: FA0013641 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 1 <br /> Owner ID OW0010754 <br /> Owner name ZUCKERMAN HERITAGE, INC ZUCKERMAN HERITAGE, INC 111 <br /> Mailing address PO BOX 487 PO BOX 487 113 <br /> STOCKTON, CA 95201 Stockton, CA 95219 114, 115, 116 <br /> Work phone 209-469-7979 209-469-7979 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0013641 <br /> Facility name DELTA BLUEGRASS CO DELTA BLUEGRASS CO 3 <br /> Site address 1030 S ARGONAUT 1030 S ARGONAUT 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95204 95204 105 <br /> Facility phone 209-469-7979 209-469-7979 102 <br /> Facility mailing address PO BOX 487 PO BOX 487 108a <br /> STOCKTON, CA 95201 STOCKTON, CA 95201 108b, 1080,108d <br /> BILLING INFORMATION <br /> Contact name KELLY DAVIS Trey Steinhart 140 <br /> Address PO BOX 487 PO Box 487 143 <br /> STOCKTON, CA 95201 Stockton, CA 95219 144, 145, 146 <br /> Contact phone 209-469-7979 2094697979 141 <br /> Contact email KDAVIS@DELTABLUEGRASS.COM steinhart4@sbcglobal.net 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SOG HW [ ] LOG 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: 00+A 0--_ Date: _�_11-k_7 <br /> Accounting: Reviewed by: Date: _7 12 / 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 Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 6 chem units PRO521045 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0540116 STACY RIVERA Active [ ] [ ] <br /> 2831 -AST FAC >/= 1,320-<10 K GAL CUMULATIVE PRO540726 STACY RIVERA Active [ 1 I 1 <br /> 4740-WASTE TIRE SITE-EXEMPT PR0534992 HARPRIT MATTU Active [ ] [ 1 <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0517983 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0517984 HAZ MAT SJC DES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533129 not assigned Inactive [ ] [ ] <br />