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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 4/10/2015 <br /> Submitted on: 4/8/2015 10:28:09AM CERS ID: 10448341 <br /> Submitted by: Jesse Diaz Email:jesse.diaz@loves.com Facility ID in CERS: FA0021886 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0009856 <br /> Owner name LOVES COUNTRY STORES OF CA Love's Travel Stops and Country Stores 111 <br /> Mailing address PO BOX 26210 PO BOX 26210 113 <br /> OKLAHOMA CITY, OK 73126 Oklahoma City, OK 73126 114, 115, 116 <br /> Work phone 405-302-6638 (405) 242-2455 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0021886 <br /> Facility name LOVES TRAVEL STOP#538 Love's Travel Stop#538 3 <br /> Site address 15250 N THORNTON RD 15250 North Thornton Road 103 <br /> City LODI Lodi 104 <br /> ZIP code 95242 95242 105 <br /> Facility phone 405-687-1060 (405) 687-1060 102 <br /> Facility mailing address PO BOX 26210 PO Box 26210 108a <br /> OKLAHOMA CITY, OK 73126 Oklahoma City, OK 73126 1086,108c,108d <br /> BILLING INFORMATION <br /> Contact name LOVES TRAVEL STOP#538 Love's Country Stores of CA 140 <br /> Address PO BOX 26210 PO Box 26210 143 <br /> OKLAHOMA CITY, OK 73126 Oklahoma City, OK 73126 144, 145, 146 <br /> Contact phone 405-687-1060 (405) 302-6638 141 <br /> Contact email jesse.diaz@loves.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: ?il at 9 I <br /> created [ ] Tiered permit APSA [ ] CalARP [ ] UST New PE: 2�r37-, <br /> Assigned to: V+ A7>,O <br /> Please bill: full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration <br /> 24Wizard by: U4-) Date: q' 10 't <br /> Accounting: Reviewed by: (nJ Date: a l2yl S Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [Acct billed [ Surcharge verified B : Date: <br /> --- -- -------- <br /> 1 Y— - --- --- -- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCE ING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 2351 -UST FACILITY-2481 COMPLIANT PR0537919 ARIS VELOSO Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0538168 ALFONSO ARAMBULA Inactive [ ] [ ] <br /> ,L3 k <br /> tt a4s-t°�� �r� <br />