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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 8/9/2017 <br /> Submitted on: 8/8/2017 3:14:38PM CERS ID: 10740295 <br /> Submitted by: Daniel Mendez Email: dmevents@yahoo.com Facility ID in CERS: incorrect <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 OW0022659 <br /> Owner name MIKE SELEY MIKE SELEY 111 <br /> Mailing address 1515 Hope St. 1515 Hope St. 113 <br /> South Pasadena, CA 91030 South Pasadena, CA 91030 114, 115, n6 <br /> Work phone 626-799-1196 626-799-1196 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0024140 <br /> Facility name FRENCH OILS LLC FRENCH OILS LLC 3 <br /> Site address 9240 S Harlan Rd 9240 S Harlan Rd 103 <br /> City French Camp French Camp 104 <br /> ZIP code 95231 95231 105 <br /> Facility phone 209-561-9114 2095619114 102 <br /> Facility mailing address 9240 S.HARLAN RD 9240 S.HARLAN RD 108a <br /> FRENCH CAMP, CA 95231 FRENCH CAMP, CA 95231 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name KAREN DALLAS KAREN DALLAS 140 <br /> Address PO BOX 112 1515 Hope St 143 <br /> FRENCH CAMP, CA 95231 South Pasadena, CA 91030 144, 145, 146 <br /> Contact phone 626-799-1196 626-799-1196 141 <br /> Contact email karen@seleyco.com karen@seleyco.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP SQG HW [ ] LOG HW [ ] RCRA HW New PR#: L <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: VkLAKl- 3 <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ j(�next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: r/ [7 <br /> ---------------------- <br /> Accounting: Reviewed by: Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [eAcct billed [ ] Surcharge verified — By: Date: <br /> --- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMEIP-Regular-Primary Location 7 chem units PRO542045 HAZA SAEED Active [ ] [ ] <br /> C,fe--{e,�, rA4 �— <br />