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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 8/18/2017 <br /> Submitted on: 8/1712017 2:45:52PM CERS ID: 10742383 <br /> Submitted by: Parker Landon Email: plandon@vehiclerecyclingservices.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 OW0008087 <br /> Owner name CAMPOS, FRANCISCO Stockton SSYAP, LLC 111 <br /> Mailing address 4900 ELLINGTON CT 3941 Park Drive, Ste. 20-114 113 <br /> SALIDA, CA 95368 E] Dorado Hills, CA 95762 114. 115, 116 <br /> Work phone 916-870-4383 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010087 <br /> Facility name MATRIX AUTO WRECKERS #2 Stockton SSYAP, LLC 3 <br /> Site address 3175 S HWY 99 RD 3175 S Hwy 99 Frontage Rd 103 <br /> City STOCKTON Stockton 104 <br /> ZIP code 95215 95205 105 <br /> Facility phone 209-323-4240 209-425-0489 102 <br /> Facility mailing address 4900 ELLINGTON CT 3175 S Hwy 99 Frontage Rd 108a <br /> SALIDA, CA 95368 Stockton, CA 95205 108b, 108c, 108d <br /> BILLING INFORMATION <br /> Contact name MATRIX AUTO WRECKERS#2 Stockton SSYAP, LLC 140 <br /> Address 4900 ELLINGTON CT 3941 Park Drive, Ste. 20-114 143 <br /> SALIDA, CA 95368 EI Dorado Hills, CA 95762 144, 145, 146 <br /> Contact phone 209-323-4240 916-870-4383 141 <br /> Contact email plandon@vehiclerecyclingservices.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] , QG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created ( ] Tiered permit [ APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: E1,9610 <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year ( ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: ¢Y"' Date: 1l'�-�7 <br /> Accounting: Rev evued by: C16 Date: _ Clerical: [ ] File [ j Relabel file [ ] Create new fife <br /> [ Acct billed S By: Date: <br /> ---- _--- <br /> ACTI7chem <br /> RAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Locations PR0520065 JAMIE LIMA Inactive <br /> 2217-APPLIANCE RECYCLER PR0521490 JEFFREY WONG Inactive [ ] ( ] <br /> 2220-SM HW GEN<5 TONSIYR PR0514163 STACY RIVERA Inactive <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO512375 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510087 HAZ MAT SJC OES Inactive <br /> 4740-WASTE TIRE SITE-EXEMPT PRO536147 BENJAMIN ESCOTTO Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531943 not assigned Inactive [ ] [ ] <br />