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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 10/10/2016 <br /> Submitted on: 10/10/2016 1:25:14PM CERS ID: 10181305 <br /> Submitted by: Beth Depaola Email: edepaola@chp.ca.gov Facility ID in CERS: FA0003682 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number-of a i Ic this Owner: 4 <br /> Owner ID 0W0002750 <br /> Owner na California Highway Pair I (� California Highway Patrol 111 <br /> Mailing ad ss P.O. Box 942898 �L 385 . Gra Line Road 113 <br /> // Sacramento, CA 94 8 TRA C 95376 114, 11 s, 11s <br /> Work phone 916-843-3800 �— (209 5-28961, 112 <br /> FACILITY FILE 1NFORMATI <br /> Facility ID FA0003682 <br /> Facility name CALIFORNIA HIGHWAY PATROL#266 CALIFORNIA HIGHWAY PATROL#266 3 <br /> Site address 385 W GRANT LINE RD 385 W GRANT LINE RD 103 <br /> City TRACY TRACY 104 <br /> ZIP code 95376 95376 105 <br /> Facility phone 209-835-8920 (209) 835-8920 102 <br /> Facility mailing address 385 W GRANT LINE RD 385 W GRANT LINE RD 108a <br /> TRACY, CA 95376 TRACY, CA 95376 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name DEPARTMENT OF CHP DEPARTMENT OF CALIFORNIA HIGHWA) 140 <br /> Address PO Box 942898 PO Box 942898 143 <br /> Sacramento, CA 94298-0001 Sacramento, CA 94298-0001 144, 145, 146 <br /> Contact phone 916-843-3540 916-843-3540 141 <br /> Contact email 142 <br /> Mail invoices to Account <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 th lendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: <br /> Accounting: Reviewed by: �Date: ]o it I t L, Clerical: [ ] File ( ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PR0519592 PETER LOMBARDI Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0513803 HERLINDA MENCHACA Active [ ] [ ] <br /> 2831 -AST FAC >/= 1,320-<10 K GAL CUMULATIVE PRO528049 HERLINDA MENCHACA Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523783 HARPRIT MATTU Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0511667 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0231904 STEVE SASSON Inactive [ ] I 1 <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0507400 STEVE SASSON Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533547 not assigned Inactive [ ] [ ] <br />