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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH U PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 12/4/2015 <br /> Submitted on: 12/3/2015 3:36:42PM CERS ID: 10646158 <br /> Submitted by: VICTOR LOPEZ Email: vlopez1274@yahoo.com Facility ID in CERS: FA0016127 <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 OW0013026 <br /> Owner name VICTOR LOPEZ&TERESA FELIX VICTOR LOPEZ 111 <br /> Mailing address 3430 GRUENSEYAVE 3430 GRUENSEY AVE 113 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 114, 115, 116 <br /> Work phone 209-518-6153 2095186153 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016127 <br /> Facility name TECH TRUCK AND AUTO INC TECH TRUCK AND AUTO INC 3 <br /> Site address 3726 S HWY 99 E FRONTAGE RD 3726 S Hwy 99 East Frontage Rd 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95215 95215 105 <br /> Facility phone 209-948-3587 2099483587 102 <br /> Facility mailing address 3430 GUERNSEYAVE 3726 S Hwy 99 East Frontage Rd 108a <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 108b,108c,1084 <br /> BILLING INFORMATION <br /> Contact name TECH TRUCK AND AUTO INC TERESA FELIX 140 <br /> Address 3430 GUERNSEY AVE 3430 GRUENSEY AVE 143 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 144, 145, 146 <br /> Contact phone Not Specified 2096881191 141 <br /> Contact email techtrucknauto@gmail.com techtrucknauto@gmail.com 142 <br /> Mai[ invoices to Account <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 calendar year [ ] next calendar year [ ] exempt from billing <br /> 45f <br /> Processed through CERS Integration Wizard by: 5Date: <br /> ---------------------------------------------- <br /> Accounting: Reviewed by: ('S Date: 12ggl/S Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PRO524133 NICHOLAS LOEHRER Active [ ] [ j <br /> 2220-SM HW GEN<5 TONSNR PR0540500 ELENA MANZO Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523974 BENJAMIN ESCOTTO Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO531602 not assigned Inactive [ ] [ ] <br />