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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 8/6/2018 <br /> Submitted on: 2/5/2018 2:13:04PM CERS ID: 10180929 <br /> Submitted by: Lamara Torosyan Email: lamara.torosyan@redcross.org Facility ID in CERS: FA0002435 <br /> Information prior to CIW processInformation after C W processing CERS <br /> OWNER INFORMATION (current EC database (current su mittal) field <br /> Number of Facilities for this Own r: 5 <br /> Owner ID OW0001860 <br /> Owner name AMERICAN RED CROSS DELTA BLOOD BA LLC 111 <br /> Mailing address 100 RED CROSS CIR PO BOX 800 113 <br /> POMONA, CA 91768 tockton, CA 95 1 114, 115, 116 <br /> Work phone 209-943-3830 ( 09) 943-3830 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0002435 <br /> Facility name DELTA BLOOD BANK meri n R d Cross 3 <br /> Site address 65 N COMMERCE ST Ql 5 5 N C RCE ST 103 <br /> City STOCKTON STOCKT 104 <br /> ZIP code 95202 Q 95202 105 <br /> Facility phone 888-942-2566 (209) 94 -3 0 102 <br /> Facility mailing address 100 RED CROSS CIR \ 65 N C mmer a St. 108a <br /> POMONA, CA 91768 Y Stoc on, CA 5202 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name American Red Cross la Torosyan 140 <br /> Address 100 RED CROSS CIR 00 Red Cross Circ e 143 <br /> POMONA, CA 91768 Pomona, CA 91768 144, 145, 146 <br /> Contact phone Not Specified (818)797-5576 141 <br /> Contact email lamara.torosyan@redcr s.org 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG 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: OAA Date: <br /> Accounting: Reviewed by: L45 Date: $1)311 g ' 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 /> 1921 -HMBP-Regular-Primary Location 2 chem units PRO530821 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN <5 TONS/YR PR0518109 STACY RIVERA Active [ ] [ ] <br /> 4530-LG QUANITY GENERATOR PR0450112 ROBERT MCCLELLON Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO518110 ONE VACANT1 Inactive [ ] [ ] <br /> 4557-MED WASTE LIMITED HAULER PR0506421 ROBERT MCCLELLON Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531672 not assigned Inactive <br /> // [ ] [ ] <br />