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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/22/2017 <br /> Submitted on: 11/7/2017 1:13:47PM CERS ID: 10646032 <br /> Submitted by: Farah Khwaja Email: farahkhwaja@aol.com Facility ID in CERS: FA0015710 <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 OW0012640 <br /> Owner name Umar Khan Umar Khan 111 <br /> Mailing address 1431 Ponce Deleon Ave 1431 Ponce Deleon Ave 113 <br /> STOCKTON, CA 95209 STOCKTON, CA 95209 114, 115, 116 <br /> Work phone 209-420-0944 2094200944 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015710 <br /> Facility name IN N OUT AUTOMOTIVE California Autosport 3 <br /> Site address 180 BUTTON AVE 180 BUTTON AVE 103 <br /> City MANTECA MANTECA 104 <br /> ZIP code 95336 95336 105 <br /> Facility phone 209-665-7247 209-665-7247 102 <br /> Facility mailing address 180 Button Ave 180 Button Ave 108a <br /> Manteca, CA 95336 Manteca, CA 95336 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name Yusaf Khan Yusaf Khan 140 <br /> Address 1431 PONCE DE LEON AVE 1431 PONCE DE LEON AVE 143 <br /> STOCKTON, CA 95209 STOCKTON, CA 95209-2658 144, 145, 146 <br /> Contact phone 209-420-0944 2094200944 141 <br /> Contact email californiaautosport209@gmail.com californiaautosport209@gmail.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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: 00r-N lb�, Date: z-��- ]� <br /> ------------------------------------------------ <br /> Accounting: Reviewed by: b6 Date: ( u111 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> f 1 Acct billP_ �- "'- By: Date: <br /> -------------------------------------------------- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1920-HMBP-Common Materials 5 chem units PR05404220' NICHOLAS LOEHRER Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PR0541921 JOHN ALANIZ Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523263 HARPRIT MATTLI Inactive [ ] [ ] <br /> e '� [Kt���N"�e C1�rJ'je� �'!� SLLV-\ N61\11. <br />