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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 5/2/2017 <br /> Submitted on: 4/28/2017 3:34:56PM CERS ID: 10182217 <br /> Submitted by: George Goulart Email: sanipak@sanipak.com Facility ID in CERS: FA0007174 <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 OW0005896 <br /> Owner name John Hall Vern Hal[ 111 <br /> Mailing address 8444 Julie Lynne Circle 23535 S. Bird Road 113 <br /> TRACY, CA 95304 TRACY, CA 95304 114, 115, 116 <br /> Work phone 209-836-2310 209-836-2310 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0007174 <br /> Facility name SAN-I-PAK INC SAN-I-PAK INC 3 <br /> Site address 23535 S BIRD RD 23535 S BIRD RD 103 <br /> City TRACY TRACY 104 <br /> ZIP code 95304 95304 105 <br /> Facility phone 209-836-2310 (209) 836-2310 102 <br /> Facility mailing address PO BOX 1183 PO BOX 1183 108a <br /> TRACY, CA 95378-1183 TRACY, CA 95378-1183 108b,1080,108d <br /> BILLING INFORMATION <br /> Contact name SAN-I-PAK INC SAN-I-PAK INC 140 <br /> Address PO BOX 1183 PO BOX 1183 143 <br /> TRACY, CA 95378-1183 TRACY, CA 95378-1183 144, 145, 146 <br /> Contact phone 209-836-2310 209-836-2310 141 <br /> Contact email 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG HW [ j 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: 0+6` Ca� Date: Z-[� <br /> Accounting: Reviewed by: �Date: y I Clerical: [ j File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 7 chem units PR0520088 NICHOLAS LOEHRER Active [ ] [ ] <br /> 2220-SM HW GEN c5 TONS/VR PR0514186 TWO VACANT2 Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512418 TWO VACANT2 Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510130 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO531702 not assigned Inactive [ ] [ ] <br />