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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 9/29/2015 <br /> Submitted on: 9/15/2015 11:56:58AM CERS ID: 10187655 <br /> Submitted by: Uyen Huynh Email superlubeplus@gmail.com Facility ID in CERS: FA0020646 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0016968 <br /> Owner name SUPERLUBE PLUS INC SUPERLUBE PLUS INC 111 <br /> Mailing address 5023 GRAY HAWK LN 1170 LINCOLN BLVD 113 <br /> DUBLIN, CA 94568 TRACY, CA 95376 114, 115, 116 <br /> Work phone 209-836-3602 2098363602 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0020646 <br /> Facility name SUPERLUBE PLUS INC SUPERLUBE PLUS INC 3 <br /> Site address 1170 LINCOLN BLVD 1170 LINCOLN BLVD 103 <br /> City TRACY TRACY 104 <br /> ZIP code 95376 95376 105 <br /> Facility phone 925-785-5443 2098363602 102 <br /> Facility mailing address 1170 LINCOLN BLVD 1170 LINCOLN BLVD 108a <br /> TRACY, CA 95376 TRACY, CA 95376 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name SUPERLUBE PLUS INC SUPERLUBE PLUS INC 140 <br /> Address 1170 LINCOLN BLVD 1170 LINCOLN BLVD 143 <br /> TRACY, CA 95376 TRACY, CA 95376 144, 145, 146 <br /> Contact phone 925-785-5443 2098363602 141 <br /> Contact email 142 <br /> Mail invoices to Faty <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: 5 O <br /> created [ ] Tiered permit`-APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: r ''F <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: <br /> —--------------------——— - — --- ---- -- -- <br /> Accounting: Reviewed by: t6 Dater a J'S Clerical: ] ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed har a 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 /> 1920-HMBP-Common Materials PRC540393 PETER LOMBARDI Active [ ] [ ] <br /> 2227-GEN 5<25 TONS PERMIT PRO535857 THUY TRAN Active [ ] [ ] <br /> 2332-EXEMPT TANK FACILITY PRO535856 THUY TRAN Active, Exempt [ ] ( ] <br /> 1616-RETAIL MARKET< 1000 SQ FT W 1 FOOD PREP PRO535928 MELISSA NISSIM Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO535858 not assigned Inactive [ ] [ ] <br />