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SAN JOAQUII JUNTY ENVIRONMENTAL HEALTH . _f'ARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 9/9/2015 <br /> Submitted on: 9/1/2015 12:57:35PM CERS ID: 10183455 <br /> Submitted by: Cara Diviney Email: cara@divineytransportation.com Facility ID in CERS: FA0010335 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008335 <br /> Owner name DAN DIVINEY Cara Diviney 111 <br /> Mailing address 5161 W 11TH ST 182 Manzanita Ln 113 <br /> TRACY, CA 95304 Tracy, CA 95376 114, 115, 116 <br /> Work phone 209-832-6181 925-339-5825 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010335 <br /> Facility name DIVINEY TRANSPORTATION SVCS DIVINEY TRANSPORTATION SVCS 3 <br /> Site address 5161 W ELEVENTH ST 5161 W ELEVENTH ST 103 <br /> City TRACY TRACY 104 <br /> ZIP code 95304 95376 105 <br /> Facility phone 209-832-6181 209-832-6181 102 <br /> Facility mailing address 5161 W 11TH ST 5161 W 11th Street 108a <br /> TRACY, CA 95304 Tracy, CA 95304 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name DIVINEY TRANSPORTATION SVCS Cara Diviney 140 <br /> Address 5161 W 11TH ST 182 Manzanita Ln 143 <br /> TRACY, CA 95304 Tracy, CA 95376 144, 145, 146 <br /> Contact phone 209-832-6181 925-339-5825 141 <br /> Contact email dpdiviney@yahoo.com cara@divineytransportation.com 142 <br /> Mai[ invoices to Account <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 [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: `l (ci If <br /> Accounting: Reviewed by: t6 Date: g110/15 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ }-Aeet-1 Illed--�- m-aharge-ve4fied-- By: Date: <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 PR0520246 MICHAEL PARISSI Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PR0514286 THUY TRAN Active [ ] [ ] <br /> 2831 -AST FAC >/= 1,320-<10 K GAL CUMULATIVE PR0540425 THUY TRAN Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0523977 HARPRIT MATTU Active [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0540265 THUY TRAN Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510335 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531283 not assigned Inactive [ ] [ ] <br />