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E- SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11/14/2014 <br /> Submitted on: 11/13/2014 4:55:OOPM CERS ID: 10181231 <br /> Submitted by: Glenda Kierstead Email: glenda@belshire.com Facility ID in CERS: FA0003603 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0002829 <br /> Owner name Tesoro Sierra Properties LLC TESORO SIERRA PROPERTIES LLC 111 <br /> Mailing address 19100 RIDGEWOOD PKWY MS: TX1-022 19100 RIDGEWOOD PKWY MS: TX1-022 113 <br /> SAN ANTONIO, TX 78259 SAN ANTONIO, TX 78259 114, 115, 116 <br /> Work phone 210-626-4994 210-626-4994 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003603 <br /> Facility name USA GAS STATION #68152* USA GAS STATION#68152* 3 <br /> Site address 401 W Kettleman Ln 401 W KETTLEMAN LN 103 <br /> City LODI LODI 104 <br /> ZIP code 95240 95240 105 <br /> Facility phone 209-368-8787 (209) 368-8787 102 <br /> Facility mailing address 19100 RIDGEWOOD PKWY 19100 RIDGEWOOD PKWY MS: TX1-022 108a <br /> SAN ANTONIO, TX 78259 SAN ANTONIO, TX 78259 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name TESORO WEST COAST COMPANY LLC TESORO SIERRA PROPERTIES LLC 140 <br /> Address 19100 RIDGEWOOD PKWY 19100 RIDGEWOOD PKWY MS: TX1-022 143 <br /> SAN ANTONIO, TX 78259 SAN ANTONIO, TX 78259 144, 145, 146 <br /> Contact phone 210-626-4994 210-626-4994 141 <br /> Contact email lisa.I gomezCa tsocorp.com ROSIE.RANGEL@TSOCORP.COM 142 <br /> Mail invoices to Facitfty f1. <br /> Program record [ ] HMBP f\ [ ] SQG HW [ ] LQG 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: iijkt� Date: tq-kkj <br /> Accounting: Reviewed by: Date: 1 1k'f File [ ] Relabel file [ ] Create new file <br /> Clerical: <br /> [ ] Ac ed [ ] Surcha�erified 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 PRO521232 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO518453 ARIS VELOSO Active [ ] [ ] <br /> 2361 -UST FACILITY PR0231346 ARIS VELOSO Active [ ] [ ] <br /> 2301 -UST STATE SURCHARGE FEE PR0508261 FATINAH ZAREEF Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507362 FATINAH ZAREEF Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE R PRO534052 not assigned Inactive [ ] [ ] <br />