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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/25/2016 <br /> Submitted on: 1/15/2016 6:24:13AM CERS ID: 10185035 <br /> Submitted by: Sheila Caballero Email: sheila.caballero@shawgrp.com Facility ID in CERS: FA0015871 <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 OW0012792 <br /> Owner name LOWE'S Home Center, LLC LOWE'S Home Center, LLC 111 <br /> Mailing address 101 Andover Park E Ste 200 c/o MailcodeA: 101 Andover Park E Ste 200 c/o MailcodeA: 113 <br /> Tukwila, WA 98188 Tukwila, WA 98188 114, 115, 116 <br /> Work phone 704-758-2000 704-758-2000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015871 <br /> Facility name LOWE'S#1545 LOWE'S#1545 3 <br /> Site address 3645 E HAMMER LN 3645 E HAMMER LN 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95212 95212 105 <br /> Facility phone 888-429-6281 888-429-6281 102 <br /> Facility mailing address 1000 LOWE'S BLVD 1000 LOWE'S BLVD 108a <br /> MOORESVILLE, NC 28117 MOORESVILLE, NC 28117 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name Rob Gass Rob Gass 140 <br /> Address 1000 LOWE'S BLVD 1000 LOWE'S BLVD 143 <br /> MOORESVILLE, NC 28117 MOORESVILLE, NC 28117 144, 145, 146 <br /> Contact phone 704-758-6033 704-758-6033 141 <br /> Contact email Robert.A.Gass@lowes.com Robert.A.Gass@lowes.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: P ROS4 O"] <br /> created [ ] Tiered permitAPSA [ ] CalARP [ ] UST New PE: k31 <br /> Assigned to: 2PY1� <br /> Please bill: [ ] full calendar year [ ] proratethis (calendar year [ ] next calendar year [ ] exempt from billing <br /> ,1 <br /> Processed through CERS Integration Wizard by: W v Date: 1 •a--5-1 Sa <br /> ------9' ----- -------- [ -----[]— — - <br /> Accountin Reviewed by: Date: t 1V t 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 /> 1921-HMBP-Regular-Primary Location PR0523492 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO536648 MICHELLE HENRY Active <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531965 not assigned Inactive [ ] [ ] <br />