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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/11/2017 <br /> Submitted on: 1/6/2017 4:15:04PM CERS ID: 10140205 <br /> Submitted by: Bryan Chen Email: Bryan.Chen@arcadis-us.com Facility ID in CERS: FA0010345 <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: 6 <br /> Owner ID OW0008345 <br /> Owner name The Home Depot U.S.A., Inc. The Home Depot U.S.A., Inc. 111 <br /> Mailing address 2455 Paces Ferry Road, C-19 2455 Paces Ferry Road, C-19 113 <br /> Atlanta, GA 30339 Atlanta, GA 30339 114, 115, 116 <br /> Work phone 770-433-8211 (770)433-8211 x 82714 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010345 <br /> Facility name THE HOME DEPOT STORE#0662 THE HOME DEPOT STORE#0662 3 <br /> Site address 3818 E Hammer Ln 3818 E Hammer Ln 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95212 95212 105 <br /> Facility phone 209-476-9600 (209) 476-9600 102 <br /> Facility mailing address 3818 E Hammer Lane 3818 E Hammer Lane 108a <br /> Stockton, CA 95212 Stockton, CA 95212 108b,10sc, t0sd <br /> BILLING INFORMATION <br /> Contact name Arcadis U.S., Inc. Arcadis U.S., Inc. 140 <br /> Address 160 Chapel Road, Suite 201 160 Chapel Road, Suite 201 C/O Complianci 143 <br /> Manchester, CT 06042 Manchester, CT 06042 144, 145, 146 <br /> Contact phone 860-645-1084 (860) 645-1084 141 <br /> Contact email tierlladministrator@arcadis-us.com tierlladministrator@arcadis.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 /> Processed through CERS Integration Wizard by: A. M Date: 1'II I I-7 <br /> Accounting: Reviewed by: tt✓ Date: 1112-111 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1620-RETAIL MKT 26-300 SQ FT(INCIDENTAL FOODS) PR0526579 JEFFREY WONG Active [ ] [ J <br /> 1921 -HMBP-Regular-Primary Location 5 chem units PR0520253 JAMIE LIMA Active [ ] [ ] <br /> 2227-GEN 5<25 TONS PERMIT PR0517913 VICKI MCCARTNEY Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512633 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510345 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534193 not assigned Inactive [ ] [ ] <br />