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E__ <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 3/19/2015] <br /> Submitted on: 112212015 3:09:15PM CERS ID: 10182741 <br /> Submitted by: Bonnie Berneiser Email: bonneb@clearwire.net <br /> Facility ID in CERS: FA0009508 <br /> information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0007508 <br /> Owner name BONNIE BERNEISER BONNIE BERNEISER 111 <br /> Mailing address PO BOX 246 101 COMMERCE ST 113 <br /> LODI, CA 95240 LODI, CA 95240 114, 115, 116 <br /> Worm phone 209-481-3589 209-481-3589 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009508 <br /> Facility name GUARANTEE REPAIR SERVICE GUARANTEE REPAIR SERVICE 3 <br /> Site address 101 COMMLRCE ST 101 COMMERCE ST 103 <br /> City LODI LODI 104 <br /> ZIP code 95240 95240 105 <br /> Facility phone 209-339-1100 (209) 339-1100 102 <br /> Facility mailing address PO BOX 246 PO BOX 246 108a <br /> VICTOR, CA 95253-0246 VICTOR, CA 95253-0246 1085,108c,108d <br /> BILLING INFORMATION <br /> Contact name GUARANTEE REPAIR SERVICE GUARANTEE REPAIR SERVICE 140 <br /> Address PO BOX 246 PO BOX 246 143 <br /> VICTOR, CA 95253-0246 VICTOR, CA 95253-0246 144, 145, 146 <br /> Contact phone 209-339-1100 209-339-1100 141 <br /> Contact email 142 <br /> Mail invoices to Facility <br /> Program record [ j HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP <br /> [ ] 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: r 'y"° Date: I�`14j <br /> Accounting: Reviewed by: _ Date: ��2371 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified 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 -HMRP-Regular-Primary Location PR0519689 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN <5 TONS/YR PRO513874 ARIS VELOSO Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO509508 HAZ MAT SJG OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO534687 not assigned Inactive [ ] [ ] <br />