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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 711112014 <br /> Submitted on: 5/19/2014 11:06:53AM CERS ID: 10440301 <br /> Submitted by: Janelie Brown Email:jbrown@kendal[compliance.com Facility ID in CERS FA0000917 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0010964 <br /> Owner name 99 CENTS ONLY STORES 99 Cents Only Stores 111 <br /> Mailing address 4000 UNION PACIFIC AVE 4000 Union Pacific Avenue 113 <br /> COMMERCE, CA 90023 Commerce, CA 90023 114, 115, 116 <br /> Work phone Not Specified (323) 980-8145 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000917 <br /> Facility name 99 CENTS ONLY STORES#157 99 Cents Only Stores#157 3 <br /> Site address 300 W KETTLEMAN LN 300 W Kettleman Ln 103 <br /> City LODI Lodi 104 <br /> Zip code 95240 95240 105 <br /> Facility phone Not Specified (2.09) 339-9103 102 <br /> Facility mailing address 4000 E UNION PACIFIC AVE 4000 Union Pacific Avenue 108x <br /> COMMERCE, CA 90023 Commerce, CA 90023 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name 99 CENTS ONLY STORES#157 Paul Dolby 140 <br /> Address 4000 E UNION PACIFIC AVE 4000 Union Pacific Avenue 143 <br /> COMMERCE, CA 90023 Commerce, CA 90023 144, 145, 146 <br /> Contact phone 213-251-2200 (323) 980-8145 ext 1987 141 <br /> Contact email Paul.Dolby@99only.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SOG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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: Date: <br /> Accounting: Reviewed by: Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Actrfil'ed [ ] Surctler ied 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 (PREPKGO 1 LTD PREP) PRO160320 NICHOLAS WIESEMAN Active [ ] [ ] <br /> 2220-SM'HW GEN<5 TONS/YR PR0538452 MICHELLE HENRY Active [ ] [ ] <br />