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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 1/18/2017 <br /> Submitted on: 1/15/2017 10:21:01PM CERS ID: 10182185 <br /> Submitted by: Regina Metzker Email: rmetzker@kpaonline.com Facility ID in CERS: FA0007087 <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: 2 <br /> Owner ID OW0005820 <br /> Owner name Paul Umdenstock Paul J Umdenstock 111 <br /> Mailing address 7120 Lincoln Oaks Rd PO BOX 690398 113 <br /> Stockton, CA 95207 STOCKTON, CA 95269 114, 115, 116 <br /> Work phone 209-870-4400 (209) 956-5244 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0007087 <br /> Facility name BIG VALLEY FORD BIG VALLEY FORD 3 <br /> Site address 3282 AUTO CENTER DR 3282 AUTO CENTER CIR 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95212 95212 105 <br /> Facility phone 209-956-5244 (209) 956-5244 102 <br /> Facility mailing address PO BOX 690398 PO BOX 690398 108a <br /> STOCKTON, CA 95269 STOCKTON, CA 95269 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name BIG VALLEY FORD BIG VALLEY FORD 140 <br /> Address PO BOX 690398 PO BOX 690398 143 <br /> STOCKTON, CA 95269 STOCKTON, CA 95269 144, 145, 146 <br /> Contact phone 209-956-5244 (209) 956-5244 141 <br /> Contact email 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: kYla&&� (W Date: 111011-7 <br /> Accounting: Reviewed by: t Date: / ((LL"/ /7 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 9 chem units PR0519374 JAMIE LIMA Active [ ] [ ] <br /> 2229-GEN 50<250 TONS PERMIT PRO505926 VICKI MCCARTNEY Active [ ] [ 1 <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0515782 VICKI MCCARTNEY Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0522793 ALFONSOARAMBULA Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511377 HAZ MAT SJC OES Inactive [ ] [ 1 <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507652 HAZA SAEED Inactive [ ] [ 1 <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534221 not assigned Inactive [ ] [ I <br /> JGriNed addrna On partO 1l>rwel-: A-ddrefs is 3282 Auly Cent <br />