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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/27/2014 <br /> Submitted on: 1/13/2014 9:35:30AM CERS ID: 10183067 <br /> Submitted by: Debra Hamlin Email: envgen@bfrc.com Facility ID in CERS: FA0009957 <br /> Information prior to CIW processing Information after CIW proces ' g CERS <br /> OWNER INFORMATION (current EC database) rrentyagrp' al) field <br /> Owner ID OW0007957 <br /> Owner name BRI DGESTONE/FIRESTONE Bridgestone Retail Operations, LLC 111 <br /> Mailing address 6102 SUNRISE MALL DR 333 East Lake Street Attn: Debra Hamlin 113 <br /> CITRUS HEIGHTS, CA 95610690 Bloomingdale, IL 60108 114, 115,116 <br /> Work phone 916-486-3852 630-259-9000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009957 <br /> Facility name BRI DGESTONE/FIRESTONE#3583 Fir a Complete Auto Care#3583 3 <br /> Site address 720 E HAMMER LN 1 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 <br /> 102 <br /> Facility mailing address 6102 SUNRISE MALL DR 333 East Lake Street Attn: Debra Hamlin-B 108a <br /> CITRUS HEIGHTS, CA 956106906 Bloomingdale, IL 60108 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name BRIDGESTONE/FIRESTONE#3583 Debra Hamlin-BSRO 140 <br /> Address 6102 SUNRISE MALL DR 333 East Lake Street 143 <br /> CITRUS HEIGHTS, CA 956106906 Bloomingdale, IL 60108 144, 145, 146 <br /> Contact phone Not Specified 630-259-9379 141 <br /> Contact email envgen@bfrc.com 142 <br /> Mail invoices to ��KAIIR✓ <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 /> ting: Reviewed by:_ Date: Clerical: File [ ] Relabel file [ ] Create new file <br /> Accoun <br /> [ ] A Bled [ ] Surch venied--- ---- 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 PR0519988 HAZA SAEED Active [ I [ ] <br /> 2228-GEN 25<50 TONS PERMIT PR0514108 Fatina Zareef Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509957 HAZ MAT SJC OES Inactive <br /> 4740-WASTE TIRE SITE-EXEMPT PRO522401 HARPRIT MATTU Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO531981 not assigned Inactive [ ] [ ] <br />