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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 3/19/2015 <br /> Submitted on: 1/28/2015 8:28:59AM CERS ID: 10182967 <br /> Submitted by: Don Silvey Email: dsilvey@geweke.com Facility ID in CERS: FA0009862 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> (current EC database) (current submittal) field <br /> OWNER INFORMATION <br /> Owner ID OW0007124 <br /> Owner name THE GEWEKE COMPANY THE GEWEKE COMPANY 111 <br /> Mailing address 871 E ONSTOTT RD 871 E ONSTOTT RD 11a, 11 11s <br /> YUBA CITY, CA 95991 YUBACITY, CA 95991 112 <br /> Work phone 530-821-4747 530-821-4747 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009862 <br /> Facility name GEWEKE AUTO & RV COLLISION CENTEI GEWEKE AUTO & RV COLLISION CENTEI 3 <br /> Site address 102 Hansen Dr 102 HANSEN DR 103 <br /> City LODI LODI 104 <br /> ZIP code 95240 95240 105 <br /> Facility phone 209-368-0561 (209) 368-0561 102 <br /> Facility mailing address PO BOX 929001 PO BOX 929001 108a <br /> YUBA CITY, CA 95992 YUBA CITY, CA 95992 108b, 1080,108d <br /> BILLING INFORMATION <br /> Contact name GEWEKE AUTO& RV COLLISION CTR DIANNE VINSON 140 <br /> Address PO BOX 929001 PO BOX 929001 143 <br /> YUBA CITY, CA 95992 YUBA CITY, CA 95992 144, 145, 146 <br /> Contact phone 209-368-0561 2093680561 141 <br /> Contact email dvinson@geweke.com dvinson@geweke.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW I ] 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: 017 Date: 3—Ij-Irj <br /> ------ -------------------------------------------- <br /> Accounting: Reviewed by: ✓I� Date: 3 Z%fl K 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 PR0519923 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PRO514067 ARIS VELOSO Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523742 BENJAMIN ESCOTTO Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509862 HAZ MAT SJC OES Inactive ( ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533265 not assigned Inactive [ ] [ ] <br />