Laserfiche WebLink
SAE--:-::IN GOUNTY ENVIRONMENTAL HEALTH f�EPARTMENT <br /> nges to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/22/2016 <br /> Submitted on: 12/96/2016 10:48:16AM <br /> Submitted by: mark edwards Email: markzxl0r@yahoo.com CERS ID: 10186633 <br /> Facility ID in CERS: PA0017555 <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 OW0014396 <br /> Owner name EDWARDS, MARK & GIBSON JENNIFER Mark Edwards 111 <br /> Mailing address 9649 THORNTON RD 9649 Thornton rd 113 <br /> STOCKTON, CA 95209 stockton, CA 95209 114, 115, 116 <br /> Work phone 2094739888 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017555 <br /> Facility name GTAUTOMOTIVE CENTER GT AUTOMOTIVE CENTER 3 <br /> Site address 720 E HAMMER LN C-7 720 E HAMMER LN C-7 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95210 95210 105 <br /> Facility phone 209-473-9888 (209)473-9888 102 <br /> Facility mailing address 720 E HAMMER LN C-7 720 E Hammer In C-7 108a <br /> STOCKTON, CA 95210 Stockton, CA 95210 108b, 1oac, 106d <br /> BILLING INFORMATION <br /> Contact name GT AUTOMOTIVE CENTER Mark Edwards 140 <br /> Address 720 E HAMMER LN C-7 9649 thornton road 143 <br /> STOCKTON, CA 95210 stockton, CA 95209 144, 145, 146 <br /> Contact phone 209-715-9026 2097159026 141 <br /> Contact email markzxl Or@yahoo.com 142 <br /> Mail invoices to Account <br /> Program record ( ] HMBP ( ] SQG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP ( ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from biiiing <br /> Processed through CERS Integration Wizard by: VA, M Date: (p <br /> Accounting: Reviewed by: J�LV2 — Date: 1-21o'111 Clerical: ( ] FileRelabel file <br /> ( J [ ] 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 /> 1920-HMBP-Common Materials 2 chem units PR0525740 HAZA SAFFD Active [ ] [ ] <br /> 2220-SM HVV GEN <5 TONS/YR PR0527375 VICKI MCCARTNEY Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533367 not assigned Inactive [ ] [ ] <br />