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SAN JOAQUIN .)UNTY ENVIRONMENTAL HEALTH ucPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> ate run: 1212-014) <br /> Submitted on: 11/19/2013 2:12:42PM CE : 10187759 <br /> Submitted by: Thomas Lyon Email: oilstop1@gmail.com Facility ID in CERS: FA0021137 <br /> Information prior to CIW processing Information after CIW processing. CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0017412 <br /> Owner name LYON, THOMAS S TTL Automotive Enterprises, Inc. 111 <br /> Mailing address 301 W KETTLEMAN LN 1113 Los Robles Street 113 <br /> LODI, CA 95240 Davis, CA 95618 114, 115, 116 <br /> Work phone 209-368-9779 (530)400-2613 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0021137 <br /> Facility name OILSTOP OILSTOP 3 <br /> Site address 301 W KETTLEMAN LN 301 W KETTLEMAN LN 103 <br /> City LODI LODI 104 <br /> Zip code 95240 95240 105 <br /> Facility phone 209-368-9779 (209) 368-9779 102 <br /> Facility mailing address 301 W KETTLEMAN LN 1113 Los Robles Street 108a <br /> LODI, CA 95240 Davis, CA 95618 108b,108c,1084 <br /> BILLING INFORMATION <br /> Contact name OILSTOP Thomas S. Lyon 140 <br /> Address 301 W KETTLEMAN LN 1113 Los Robles Street 143 <br /> LODI, CA 95240 Davis, CA 95618 144, 145, 146 <br /> Contact phone 209-368-9779 (530)400-2613 141 <br /> Contact email chicot12004@yahoo.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ j prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: <br /> Accounting: Reviewed by: Date: 02 Clerical: [File [ ( Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge-verified —— /By`:—__—— Date_ <br /> ---------- ---- �- -- --- <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 PR0536822 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2228-GEN 25<50 TONS PERMIT PR0536804 ARTS VELOSO Active [ ] [ ] <br /> 2332-EXEMPT TANK FACILITY PR0535303 ARIS VELOSO Inactive [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0538222 ARIS VELOSO Active, Exempt [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE F PR0536805 not assigned Inactive [ ] [ ] <br />