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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 12/5/2016 <br /> Submitted on: 11/29/2016 1:47:15PM CERS ID: 10181437 <br /> Submitted by: Krystal Jacks Email: krystal@jhsimpson.com Facility ID in CERS: FA0003806 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> (current EC database) (current submittal) field <br /> OWNER INFORMATION Number of Facilities for this Owner: 1 <br /> Owner ID OW0002822 111 <br /> J.H. SIMPSON CO., INC <br /> Owner name J.H. SIMPSON CO., INC <br /> Mailing address PO BOX 8640 PO BOX 8640 113 <br /> STOCKTON, CA 95208 STOCKTON, CA 95208 114. 115, 116 <br /> Work phone 209-466-1477 209-466-1477 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003806 <br /> Facility name J.H. SIMPSON CO., INC J.H. SIMPSON CO., INC 1303 <br /> Site address 4025 CORONADO AVE 4025 CORONADO AVE 104 <br /> City STOCKTON STOCKTON <br /> ZIP code 95204 95204 105 <br /> Facility phone 209-466-1477 (209) 466-1477 102 <br /> Facility mailing address PO BOX 8640 PO BOX 8640 108a <br /> STOCKTON, CA 95208 STOCKTON, CA 95208 10eb,108c.toed <br /> BILLING INFORMATION <br /> Contact name PAM RIEGER Krystal jacks 140 <br /> Address PO BOX 8640 PO BOX 8640 143 <br /> STOCKTON, CA 95208 STOCKTON, CA 95208 144, 145, 146 <br /> Contact phone 209-466-1477 209-466-1477 141 <br /> Contact email pam@jhsimpson.com krystal@jhsimpson.com 142 <br /> Mail invoices to Owner <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 Is Iendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: 12/611W <br /> Accounting: Reviewed by: L'6 Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ----- -- ------- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 4 chem units PRO526240 HAZA SAEED Active [ ] [ ] <br /> 2221 -USED OIL ONLY-<5 TONS/YR PRO538460 STACY RIVERA Active [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0231068 LETITIA BRIGGS Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534381 not assigned Inactive [ ] [ ] <br />