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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/21/2014 <br /> Submitted on: 2/10/2014 10:20:15AM CERS ID: 10181683 <br /> Submitted by: David Heinze Email: dhcalosso@gmail.com Facility ID in CERS: FA0004740 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0003642 <br /> Owner name M CALOSSO & SON INC Mike Calosso 111 <br /> Mailing address 1947 E MINER AVE 1947 E MINER AVE 113 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 114, 115,116 <br /> Work phone 209-466-8994 (209)466-8994 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0004740 <br /> Facility name M CALOSSO&SON INC M CALOSSO &SON INC 3 <br /> Site address 1947 E MINER AVE 1947 E MINER AVE 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95205 95205 105 <br /> Facility phone 209-466-8994 (209)466-8994 102 <br /> Facility mailing address 1947 E MINER AVE 1947 E MINER AVE 108a <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 108b,108c,1o8d <br /> BILLING INFORMATION <br /> Contact name M CALOSSO&SON INC M CALOSSO &SON INC 140 <br /> Address 1947 E MINER AVE 1947 E MINER AVE 143 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 144, 145, 146 <br /> Contact phone 209466-8994 (209)466-8994 141 <br /> Contact email 142 <br /> Mail invoices to Owner✓ <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calIlendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: ll�Date:. Z 1 Y <br /> -------------- <br /> ----------- <br /> Accounting: Reviewed by: ele Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] ct btlf [ ] Surcha r led B : Date: <br /> ———— <br /> Ac ed <br /> ------ — ------------- —y- <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 PRO519723 HAZA SAEED Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0528486 JEFFREY WONG Active [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PRO500360 LETITIA BRIGGS Inactive [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PRO500879 LETITIA BRIGGS Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO509558 HAZ MAT SJC DES Inactive <br /> 2840-AST EXEMPT FAC <1,320 GAL PRO528485 JEFFREY WONG Active, Exempt [ ] [ ] <br />