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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/19/2014 <br /> Submitted on: 3/3/2014 11:59:33AM CERS ID: 10180585 <br /> Submitted by: rupinder padda Email: msspetroinc@yahoo.com Facility ID in CERS: FA0000392 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000322 <br /> Owner name MSS PETRO INC MSS PETRO INC 111 <br /> Mailing address 7887 LEEWARD CT 7887 LEEWARD CT 113 <br /> TRACY, CA 953048768 TRACY, CA 95304-8768 114, 115,116 <br /> Work phone 209-334-3233 209-914-8735 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000392 <br /> Facility name FLAMES LIQUOR FLAMES LIQUOR 3 <br /> Site address 1301 W KETTLEMAN LN 1301 W KETTLEMAN LN 103 <br /> City LODI LODI 104 <br /> Zip code 95242 95242 <br /> 105 <br /> Facility phone 209-334-3233 (209) 334-3233 102 <br /> Facility mailing address 1301 W KETTLEMAN LN 1301 W KETTLEMAN LN 108a <br /> LODI, CA 95242 LODI, CA 95242 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name FLAMES LIQUOR FLAMES LIQUOR 140 <br /> Address 1301 W KETTLEMAN LN 1301 W KETTLEMAN LN 143 <br /> LODI, CA 95242 LODI, CA 95242 144, 145. 145 <br /> Contact phone 209-334-3233 209-914-8735 141 <br /> Contact email 142 <br /> Mail invoices to Facility ✓ <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: �XA Date: 14-kc,•( j <br /> — ------------- <br /> — _ <br /> Accounting: Revjewed by: Date: Clerical: File [ ] Relabel file [ ] Create new file <br /> [ ] Ac Illed [ ] Surc a 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 /> 1618-RETAIL MKT>2000 SO FT (PREPKGD/LTD PREP) PRO160281 KADEANNE LINHARES Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PR0519604 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO518926 ARIS VELOSO Active [ ] [ ] <br /> 2301 -UST STATE SURCHARGE FEE PR0507805 GARRETT BACKUS Inactive [ ] [ ] <br /> 2361 -UST FACILITY PR0231342 ARIS VELOSO Active <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507244 GARRETT BACKUS Inactive <br />