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SAN JOAQUI OUNTY ENVIRONMENTAL HEALTH VEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> I Date run: 11/30/2015 <br /> Submitted on: 11/25/2015 11:13:17AM QERS ID: 10187745 <br /> Submitted by: John Watson Email:jwatson@pdsindy.com Facility IP in CERS: FA0021036 <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 OW0017314 <br /> Owner name PRIME LOGISTICS CORPORATION Prime Distribution Services 111 <br /> Mailing address 1919 BOEING WAY 1919 Boeing Way 113 <br /> STOCKTON, CA 95206 Stockton, CA 95206 114, 115, 116 <br /> Work phone 209-982-4601 209-982-4601 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0021036 <br /> Facility name PRIME DISTRIBUTION SERVICE INC PRIME DISTRIBUTION SERV�CE INC 3 <br /> Site address 1919 BOEING WAY 1919 BOEING WAY 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95206 95206 i 105 <br /> Facility phone 209-982-4601 209-824-6010 I 102 <br /> Facility mailing address 1919 BOEING WAY 1919 Boeing Way 108a <br /> STOCKTON, CA 95206 Stockton, CA 95206 108b,108c,1084 <br /> BILLING INFORMATION <br /> Contact name PRIME DISTRIBUTION SERVICE INC Prime Distribution Services INC 140 <br /> Address 1919 BOEING WAY 1919 Boeing Way I 143 <br /> STOCKTON, CA 95206 Stockton, CA 95206 144, 145, 146 <br /> Contact phone 209-982-4601 209-982-4601 141 <br /> Contact email jwatson@pdsindy.com jwatson@pdsindy.com 142 <br /> Mail invoices to Account <br /> Program record HMBP SQG HW LQG HW RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: I <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ 3 exempt from billing <br /> Processed through CERS Integration Wizard by: 17YA Date: <br /> Accounting: Reviewed by: b6 Date: I41 - Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ---------------------------------------------------- <br /> I <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 PR0536628 ROBERT LOPEZ Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0538080 HARPRIT MATTU Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0536787 HAZ MAT SJC OES Inactive <br /> i <br /> I <br /> I <br /> l <br /> I <br />