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SAN JOAQUI UOCN NTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> FChanges to EnvisionConnect by CERS Integration Wizard Date run: 512412017 <br /> CERS ID: 10646032 <br /> Submitted on: 5/22/2017 3:06:30PM Facility ID in CERS: FAD015710 <br /> Submitted by: Farah Khwaja Email: farahkhwaja@aol.com <br /> Information prior to CIW processing Information after CIW processing CERS <br /> (current EC database) <br /> (current submittal) field <br /> OWNER INFORMATION Number of Facilities for this Owner: 1 <br /> Owner ID OW0012640 111 <br /> Owner name CALIFORNIAAUTO SPORTS Umar Khan 113 <br /> Mailing address 5602 NATOMA CIR 1431 Ponce Deleon Ave 114, 115, 116 <br /> STOCKTON, CA 95219-7119 STOCKTON, <br /> CA 95209 112 <br /> Work phone <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015710 3 <br /> Facility name CALIFORNIAAUTO SPORTS IN N OUT AUTOMOTIVE 103 <br /> Site address 180 BUTTON AVE 180 BUTTON AVE <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 5602 NATOMA CIR 180 Button Ave 108a <br /> STOCKTON, CA 95219-7119 Manteca, CA 95336 106b,108c,1084 <br /> BILLING INFORMATION <br /> Contact name CALIFORNIAAUTO SPORTS Yusaf Khan 140 <br /> Address 5602 NATOMA CIR 1431 PONCE DE LEON AVE 143 <br /> STOCKTON, CA 95219-7119 MANTECA, CA 95336 144, 145, 146 <br /> Contact phone Not Specified 2094200944 141 <br /> Contact email californiaautosport209@gmail.com 142 <br /> Mail invoices to Fa� p <br /> Program record [ ] HMBP -P' SQG HW [ ] LQG HW [ ] RCRA HW New PR#: ��5`119 I <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: /}L.Ar4 -L- <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: 5 'yam' I I <br /> )� - - --- - --- - - -- -- _ — <br /> Accounting: Reviewed by: M✓ Date: �/ 1 Clerical: [ ] 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 /> 1920-HMBP-Common Materials 5 chem units PRO540422 NICHOLAS LOEHRER Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523263 HARPRIT MATTLI Active [ ] [ ] <br /> bnv A, <br /> -"go ;11-7 <br />