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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/21/2014 <br /> Submitted on: 10/21/2013 2:56:43PM CERS ID: 10181699 <br /> Submitted by: mansoor karimi Email: mansoork209@yahoo.com Facility ID in CERS: FA0004959 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0014626 <br /> Owner name KARIMI, MANSOOR mansoor karimi 111 <br /> Mailing address 2111 CABANA LN 930 E dr martin luther king jr blvd 113 <br /> TRACY, CA 95377 Stockton, CA 95206 114, 115, 116 <br /> Work phone 209-463-9500 2094639400 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0004959 <br /> Facility name TRI VALLEYAUTO DISMANTLERS TRI VALLEY AUTO DISMANTLERS 3 <br /> Site address 930 E DR MARTIN LUTHER KING JR BLVE 930 E DR MARTIN LUTHER KING JR BLVE 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95206 95206 <br /> 05 <br /> Facility phone 209-463-9500 (209)463-9500 102 <br /> Facility mailing address 930 E DR MARTIN LUTHER KING JR BLVE 930 E Dr. martin luther king jr blvd 108a <br /> STOCKTON, CA 95206 Stockton, CA 95206 108b, iaac,108d <br /> BILLING INFORMATION <br /> Contact name TRI VALLEY AUTO DISMANTLERS mansoor karimi 140 <br /> Address 930 E DR MARTIN LUTHER KING JR BLVE 930 E dr martin luther king jr blvd 143 <br /> STOCKTON, CA 95206 Stockton, CA 95206 144, 145, 146 <br /> Contact phone Not Specified 2094639400 141 <br /> Contact emailJ 142 <br /> Mail invoices to Facility, <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: (&P Date: bj <br /> 2� V <br /> Accounting: Reviewed by:_�Dater Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct _ed [ ] Surchar erifi d _By:_ Date_ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1920-HMBP-Common Materials PR0521105 ROBERT LOPEZ Active [ ] [ ] <br /> 2217-APPLIANCE RECYCLER PR0521509 STACY RIVERA Inactive [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO521746 STACY RIVERA Inactive [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0517682 STACY RIVERA Active [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PRO500994 LETITIA BRIGGS Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0517683 LETITIA BRIGGS Inactive <br /> 1 4740-WASTE TIRE SITE-EXEMPT PR0523946 ALFONSO ARAMBULA Active [ ] [ ] <br />