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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 117/2016 <br /> Submitted on: 1/5/2016 2:10:03PM CERS ID: 10187055 <br /> Submitted by: Regina Metzker Email: rmetzker@kpaonline.com Facility ID in CERS: FA0019100 <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 OW0018137 <br /> Owner name Lithia of Stockton Inc Lithia of Stockton Inc 111 <br /> Mailing address 3077 E HAMMER LN 3077 E HAMMER LN 113 <br /> STOCKTON. CA 95212 STOCKTON, CA 95212 114, 115,116 <br /> Work phone 209-956-6500 209-956-6500 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019100 <br /> Facility name STOCKTON NISSAN STOCKTON NISSAN 3 <br /> Site address 3077 E HAMMER LN 3077 E HAMMER LN 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95212 95212 105 <br /> Facility phone 209-956-6500 (209) 956-6500 102 <br /> Facility mailing address 3077 E HAMMER LN 3077 E HAMMER LN 108a <br /> STOCKTON, CA 95212 STOCKTON, CA 95212 108b,10e0,108d <br /> BILLING INFORMATION )���� (��%y <br /> Contact name STOCKTON NISSAN Stockton Nis n I�IM ✓ �\ 140 <br /> Address 3077 E HAMMER LN PO Box 11 �/ �' `y 143 <br /> STOCKTON. CA 95212 ST O , CA 95269-1180 144, 145, 146 <br /> Contact phone 209-956-6500 20 5 00 N 141 <br /> Contact emailr.m / 142 <br /> Mail invoices to Account yry <br /> Program record [ ] HMBP [ ] SOG HW [ ] LQG HW [ ] RCRA HW New PtR,#V: <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: _Date: t b <br /> Accounting: Reviewed by: Date: ] 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 /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PRO528772 JAMIE DE LA ROSA Active <br /> 2227-GEN 5<25 TONS PERMIT PRO528320 FATINAH ZAREEF Active [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0528319 FATINAH ZAREEF Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0528247 ANGELICA SANDOVAL MAI Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE A PR0533074 not assigned Inactive [ ] [ ] <br />