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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11/23/2016 <br /> Submitted on: 11/16/2016 7:31:22PM CERS ID: 10184885 <br /> Submitted by: Thomas Parlet Email: dandsautomotiverepair@yahoo.com Facility ID in CERS: FA0015163 <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: 1 <br /> Owner ID OW0012143 <br /> Owner name Tom Parlet Tom Parlet 111 <br /> Mailing address 15257 S Inheritance Way 15257 Inheritance Way 113 <br /> Manteca, CA 95336 Manteca, CA 95336 114, 115, 116 <br /> Work phone 209-923-7502 2099237502 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015163 <br /> Facility name D&S AUTOMOTIVE REPAIR D&S AUTOMOTIVE REPAIR 3 <br /> Site address 15257 S INHERITANCE WAY STE C 15257 S Inheritance Way Ste C 103 <br /> City Manteca Manteca 104 <br /> ZIP code 95336 95336 105 <br /> Facility phone 209-825-4988 2098254988 102 <br /> Facility mailing address 15257 S Inheritance Way 15257 Inheritance Way 108a <br /> Manteca, CA 95336 Manteca, CA 95336 108b, 1080,1084 <br /> BILLING INFORMATION <br /> Contact name D&S AUTOMOTIVE REPAIR Tom Parlet 140 <br /> Address 15257 S Inheritance Way 15257 Inheritance Way 143 <br /> Manteca, CA 95336 Manteca, CA 95336 144, 145, 146 <br /> Contact phone Not Specified 2099237502 141 <br /> Contact email dandsautomotiverepair@yahoo.com dandsautomotiverepair@yahoo.com 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 /> I <br /> Processed through CERS Integration Wizard by: �. ` Date: <br /> Accounting: Reviewed by: Date: 11 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 /> 1920-HMBP-Common Materials PR0522252✓ NICHOLAS LOEHRER Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0523226 ELENA MANZO Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0528783 ANGELICA SANDOVAL MAI Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533104 not assigned Inactive [ ] [ ] <br />