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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 5/10/2016 <br /> Submitted on: 3/31/2016 7:17:19AM CERS ID: 10184015 <br /> Submitted by: gage stahlberg Email: gstahlberg@kpaonline.com Facility ID in CERS: FA0010988 <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 I D OW0008988 <br /> Owner name DORNOCH INC DORNOCH INC 111 <br /> Mailing address 3500 AUTO PLAZA WAY 3500 AUTO PLAZA WAY 113 <br /> TRACY, CA 95304 TRACY, CA 95304 114, 115, 116 <br /> Work phone 209-835-4821 209-835-4821 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010988 <br /> Facility name TRACY FORD TRACY FORD 3 <br /> Site address 3500 AUTO PLAZA WAY 3500 AUTO PLAZA WAY 103 <br /> City TRACY TRACY 104 <br /> ZIP code 95304 95304 105 <br /> Facility phone 209-835-4821 209-835-4821 102 <br /> Facility mailing address 3500 AUTO PLAZA WAY 3500 AUTO PLAZA WAY 108a <br /> TRACY, CA 95304 TRACY, CA 95304 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name Maria Mueller Maria Mueller 140 <br /> Address 3500 AUTO PLAZA WAY 3500 AUTO PLAZA WAY 143 <br /> TRACY, CA 95304 TRACY, CA 95304 144, 145, 146 <br /> Contact phone 209-835-4821 209-835-4821 141 <br /> Contact email mmueller@tracyford.com mmueller@tracyford.com 142 <br /> Mail invoices to Account <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 calendar year [ ] exempt from billing <br /> r <br /> Processed through CERS Integration Wizard by: U� Date: -,I 0 'kb <br /> -------------------------------------------------- <br /> Accounting: Reviewed by: Lt? Date: X11211(0 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ rch ified 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 /> 1921 -HMBP-Regular-Primary Location PR0520590 PETER LOMBARDI Active [ ] [ ] <br /> 2228-GEN 25<50 TONS PERMIT PRO514484 VICKI MCCARTNEY Active [ ] [ ] <br /> 2831 -AST FAC >/= 1,320-<10 K GAL CUMULATIVE PR0528233 VICKI MCCARTNEY Active <br /> 4740-WASTE TIRE SITE-EXEMPT PR0522404 ALFONSO ARAMBULA Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510988 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534536 not assigned Inactive [ ] [ ] <br /> �-�•rnl etA <br />