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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 8/6/2018 <br /> Submitted on: 1/9/2018 10:10:38AM CERS ID: 10183067 <br /> Submitted by: Adrian M. Gonzales Email: adgonzal@bfrc.com Facility ID in CERS: FA0009957 <br /> Information prior to CIW proces 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 OW0007957 <br /> Owner name Bridgestone Retail Operations, L Bridgestone Retail Operations, LLC 111 <br /> Mailing address 333 East Lake Street Attn: Env nmental-E 200 4th Ave South Attn: Environmental-BS 113 <br /> Bloomingdale, IL 60108 Nashville, TN 37201 114, 115, 116 <br /> Work phone 630-259-9216 615-937-9379 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009957 <br /> Facility name FIRESTONE COMPLETE AUTO CARE#02 Firestone Complete Auto Care#028746 3 <br /> Site address 720 E HAMMER LN STE 1 720 E HAMMER LN 1 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95210 95210 105 <br /> Facility phone 209-951-2403 209-951-2403 102 <br /> Facility mailing address 333 East Lake Street Attn: Environmental-E 200 4th Ave South Attn: Environmental-BS 108a <br /> Bloomingdale, IL 60108 Nashville,TN 37201 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name FIRESTONE COMPLETE AUTO CARE#02 Adrian M. Gozales-BSRO 140 <br /> Address 200 FOURTH AVE SOUTH 200 4th Ave South Attn: Environmental-BS 143 <br /> NASHVILLE, TN 37201 Nashville, TN 37201 144, 145, 146 <br /> Contact phone 615-937-9216 615-937-9216 141 <br /> Contact email envgen@bfrc.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. Date: <br /> Accounting: Reviewed by: Date: g 1 ►3I 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 /> 1921 -HMBP-Regular-Primary Location 17 chem units PR0519988 JAMIE LIMA Active [ ] [ ] <br /> 2227-GEN 13<25 TONS PERMIT PR0514108 VICKI MCCARTNEY Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512245 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509957 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0522401 HARPRIT MATTU Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531981 not assigned Inactive [ ] [ ] <br />