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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/20/2014 <br /> Submitted on: 4/8/2013 11:33:42AM CERS ID: 10180657 <br /> Submitted by: Paul Canepa Email: canepa0@yahoo.com Facility ID in CERS: FA0000799 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000629 <br /> Owner name Marion Canepa Marion Canepa 111 <br /> Mailing address 642 N HUNTER ST 642 N HUNTER ST <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 114, 153116 <br /> Work phone 209-465-6114 2094656114 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000799 <br /> Facility name CANEPAS CAR WASH STORE CANEPAS CAR WASH STORE 3 <br /> Site address 642 N HUNTER ST 642 N HUNTER ST 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95202 95202 105 <br /> Facility phone 209-948-1636 (209) 948-1636 <br /> 102 <br /> Facility mailing address 642 N HUNTER ST 642 N HUNTER ST 108a <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name CANEPAS CAR WASH STORE CANEPAS CAR WASH STORE 140 <br /> Address 642 N HUNTER ST 642 N HUNTER ST 143 <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 144, 145, 146 <br /> Contact phone 209-948-1636 2099481636 141 <br /> Contact email 142 <br /> Mail invoices to Facility al <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: 6.)'0'j <br /> ------ ----- -- -------- ------ -- --- -- - <br /> Accounting. Reviewed by:_ �Date: Clerical: y File [ ] Relabel file [ ] Create new file <br /> [ ] Acc led [ ] Surch vers led B y: Date: <br /> ---------- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> JProgram Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1616-RETAIL MARKET<1000 SO FT W/FOOD PREP PRO163198 LEYNA HUYNH Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PRO519725 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PRO526834 JEFFREY WONG Active [ ] [ ] <br /> 2301 -UST STATE SURCHARGE FEE PRO515538 LETITIA BRIGGS Inactive [ ] [ ] <br /> 2361 -UST FACILITY PR0231148 JEFFREY WONG Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507263 LETITIA BRIGGS Inactive [ ] [ ] <br />