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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/3/2018 <br /> Submitted on: 11/1/2017 8:09:21AM CERS ID: 10744765 <br /> Submitted by: Jason White Email:jwhite@eastbaytire.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 OW0013273 <br /> Owner name EAST BAY TIRE CO George Pehanick 111 <br /> Mailing address 2200 HUNTINGTON DR BLDG C 2200 Huntington Drive Bldg C 113 <br /> FAIRFIELD, CA 94533 Fairfield, CA 94533 114, 115, 116 <br /> Work phone 707-437-4700 707-437-4700 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0005189 <br /> Facility name East Bay Tire CO East Bay Tire CO 3 <br /> Site address 2807 S HIGHWAY 99 FRONTAGE RD 2807 State Hwy 99 West Frontage Rd 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95215 95215 105 <br /> Facility phone 866-706-8935 866-706-8935 102 <br /> Facility mailing address 2200 HUNTINGTON DR BLDG C 2807 State Hwy 99 west Frontage Road 108a <br /> FAIRFIELD, CA 94533 Stockton, CA 95215 1081b,108c,108d <br /> BILLING INFORMATION <br /> Contact name East Bay Tire CO Erlinda Caragan 140 <br /> Address 2200 HUNTINGTON DR BLDG C 2200 HUntington Drive 143 <br /> FAIRFIELD, CA 94533 Fairfield, CA 94533 144, 145, 146 <br /> Contact phone 702-402-7709 702-402-7709 141 <br /> Contact email ecaragan@eastbaytire.com 142 <br /> Mail invoices to Account <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: ayh Date: I -3`liq <br /> y <br /> Accounting: Reviewed �by: Date: 7 � Clerical: [ ] File [ ] Relabel file [ ] 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 /> 1921 -HMBP-Regular-Primary Location 8 chem units PR0524480✓ JAMIE LIMA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO514365 THREE VACANT3 Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO512810 THREE VACANT3 Inactive [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0501692 LETITIA BRIGGS Inactive [ ] ( ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510522 HAZ MAT SJC OES Inactive [ ] I ] <br /> L�c�nr�e Wtptwal u`5 (ler�r��l`L'^^�. <br />