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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 9/12/2017 <br /> Submitted on: 9/12/2017 1:26:32PM 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 AMBERLAND COMPOSITES LLC George Pehanick 111 <br /> Mailing address 3632 DUCK CREEK DR STE F 2200 Huntington Drive Bldg C 113 <br /> STOCKTON, CA 952157940 Fairfield, CA 94533 114, 115, 116 <br /> Work phone 707-437-4700 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0005189 <br /> Facility name AMBERLAND COMPOSITES LLC East Bay Tire CO 3 <br /> Site address 2807 S HWY 99 2807 State Hwy 99 West Frontage Rd 103 <br /> City STOCKTON Stockton 104 <br /> ZIP code 95205 95215 105 <br /> Facility phone 209-460-1616 866-706-8935 102 <br /> Facility mailing address 3632 DUCK CREEK DR STE F 2807 State Hwy 99 west Frontage Road 108a <br /> STOCKTON, CA 952157940 Stockton, CA 95215 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name AMBERLAND COMPOSITES LLC Erlinda Caragan 140 <br /> Address 3632 DUCK CREEK DR STE F 2200 Huntington Drive 143 <br /> STOCKTON, CA 952157940 Fairfield, CA 94533 144, 145, 146 <br /> Contact phone 209-460-1616 702-402-7709 141 <br /> Contact email ecaragan@eastbaytire.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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 <br /> calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integrations Wizard by: �r^^ � � <br /> Date: a41-( <br /> Accounting: Reviewed by: //Y& 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 Read Inactivated <br /> 1921 -HMBP-Regular-Primary Location 1 chem units PR0594480✓ ROBERT LOPEZ Inactive [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO514365 THREE VACANT3 Inactive [v( [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512810 THREE VACANT3 Inactive [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0501692 LETITIA BRIGGS Inactive [ ] [ ] <br /> 2399-UNIFIED PPrpRO7GRAM FAC STATE SURCHARGE FEE PRO510522 HAZ MAT SJC OES Inactive [ ] [ ] <br />