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E__ <br /> ::ANJOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS integration Wizard <br /> Date run: 6/121/20]14 <br /> Submitted on: 5/2/2014 8:31:38AM <br /> 35 <br /> Submitted by: Charles Bittle Email: ebittle rz chevron.com CERS ID: 1 <br /> Facility ID in CERS: FA000 3A000371212 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0001987 <br /> Owner name CHEVRON CHEVRON PRODUCTS COMPANY (A DIVI 111 <br /> Mailing address P.Q. Box 6004 L3325/Al P.O. BOX 6004, ATTN: PERMIT DESK 113 <br /> SAN RAMON, CA 94583 SAN RAMON, CA 94583 114, 115, 116 <br /> Work phone 925-842-9002 (925) 842- 9002 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003712 <br /> Facility name CHEVRON STATION #94275* CHEVRON STATION #94275* 3 <br /> Site address 2905 W BENJAMIN HOLT DR 2905 W BENJAMIN HOLT DR 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95207 95207 105 <br /> Facility phone 209-478-5555 (209) 478-5555 102 <br /> Facility mailing address PO BOX 6004 1 1_2375-133 P.O. BOX 6004. ATTN: PERMIT DESK 108a <br /> SAN RAMON, CA 94583 SAN RAMON, CA 94583 108b, 108c, 1064 <br /> BILLING INFORMATION <br /> Contact name CHEVRON STATION #94275* CHEVRON PRODUCTS COMPANY (A DIVI 140 <br /> Address PO BOX 6004/ 1_2375-133 P.O. BOX 6004, ATTN: PERMIT DESK 143 <br /> SAN RAMON, CA 94583 SAN RAMON, CA 94583 144, 145, 146 <br /> Contact phone Not Specified (925) 842-9002 141 <br /> Contact email PERMITDESK@CHEVRON.COM 142 <br /> Mail invoices to Facility-, <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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 /> Processed through CERS Integration Wizard by: Date: �p•e��' � <br /> Accounting: Reviewed by: _i10 Date: 1,19 <br /> ,� ~ Clerical: /File [ ] Relabel file [ ] Create new file <br /> [ ] Ac illed j ] Surchar Werlfled By Date: <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 PRO519641 HAZA SAEED Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0517536 Fatina Zareef Active [ ] [ ] <br /> 2301 -UST STATE SURCHARGE FEE PR0507725 MICHAEL KITH Inactive [ ] [ ] <br /> 2351 -UST FACILITY-2481 COMPLIANT PR0231952 Fatina Zareef Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507414 MICHAEL KITH Inactive [ ] [ ] <br />