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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 4/6/2017 <br /> Submitted on: 3/7/2017 3:37:17PM CERS ID: 10440307 <br /> Submitted by: Janelle Brown Email:jbrown@kcgenviro.com Facility ID in CERS: FA0003183 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 4 <br /> Owner ID OW0010964 <br /> Owner name 99 Cents Only Stores 99 Cents Only Stores 111 <br /> Mailing address 4000 Union Pacific Avenue 4000 Union Pacific Avenue 113 <br /> Commerce, CA 90023 Commerce, CA 90023 114, 115,116 <br /> Work phone 323-980-8145 (323) 980-8145 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003183 <br /> Facility name 99 CENTS ONLY STORES#185 99 Cents Only Stores#185 3 <br /> Site address 1320 W ELEVENTH St 1320 W 11th St 103 <br /> City TRACY Tracy 104 <br /> ZIP code 95376 95376 105 <br /> Facility phone 209-839-9619 (209) 839-9619 102 <br /> Facility mailing address 4000 Union Pacific Avenue 4000 Union Pacific Avenue 108a <br /> Commerce, CA 90023 Commerce, CA 90023 1M,108c,1084 <br /> BILLING INFORMATION <br /> Contact name 99 CENTS ONLY STORES#185 Edgar Flores 140 <br /> Address 4000 Union Pacific Avenue 4000 Union Pacific Avenue 143 <br /> Commerce, CA 90023 Commerce, CA 90023 144. 145, 146 <br /> Contact phone Not Specified (323) 980-8145 ext 1383 141 <br /> Contact email edgar.flores@99only.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this A—calendaryear [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: ` y-1 0^l Date: 4-&-17 <br /> -------------------------------------------------- <br /> Accounting: Reviewed by:_I-A Date: 9V/1 1 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 /> 1618-RETAIL MKT>2000 SQ FT (PREPKGD/LTD PREP) PRO161629 MELISSA NISSIM Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location i chem units PRO539370 NICHOLAS LOEHRER Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO538450 BETTY HO Active [ ] [ ] <br />