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SAN JOAQUIR-16OUNTY ENVIRONMENTAL HEALTH brEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/25/2016 <br /> Submitted on: 1/15/2016 6:21:28AM CERS ID: 10187019 <br /> Submitted by: Sheila Caballero Email: sheila.caballero@shawgrp.com Facility ID in CERS: FA0018976 <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 OW0015613 <br /> Owner name Lowe's Home Center, LLC Lowe's Home Center, LLC 111 <br /> Mailing address 101 Andover Park East, Ste 200 c/o Mailcod 101 Andover Park East, Ste 200 c/o Mailcod 113 <br /> Tukwila, WA 98188 Tukwila, WA 98188 114, 115, 116 <br /> Work phone 206-242-8570 206-242-8570 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0018976 <br /> Facility name LOWE'S#1430 LOWE'S#1430 3 <br /> Site address 512 LUCE AVE 512 LUCE AVE 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95203 95203 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 29117 MOORESVILLE, NC 29117 108b, 1080,toed <br /> BILLING INFORMATION <br /> Contact name LOWE'S#1430 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 [ ] HMQP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [� APSA [ ] CalARP [ ] UST New PE: 'LIS ' iy- <br /> /9 Assigned to: JL� v <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: � - s 'L <br /> ------------------------ <br /> Accounting: Reviewed by: Date: I a- ](, 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 -HMSP-Regular-Primary Location PRO528006 ROBERT LOPEZ Active ( ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PRO539208 STACY RIVERA Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO531703 not assigned Inactive [ ] [ ] <br />