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SAN JOAQUIIl-6OUNTY ENVIRONMENTAL HEALTH-onPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/30/2015 <br /> Submitted on: 12/28/2015 3:47:37PM CERS ID: 10654036 <br /> Submitted by: Rebecca Cottrill Email: rcottril@raleys.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 : 7 <br /> Owner ID OW0000691 <br /> Owner name RALEYS Raley's Supermarkets 111 <br /> Mailing address 500 W CAPITOL AVE 500 WEST CAPITOL AVE 113 <br /> WEST SACRAMENTO, CA 95605 WEST SACRAMENTO, CA 95605 114, 115, 116 <br /> Work phone 916-373-3333 916-373-3333 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000876 �erl fytt45a�P <br /> Facility name RALEYS#311 Raleys#311 ' P 3 <br /> Site address 1280 LATHROP RD 1280 Lathrop Rd 103 <br /> City MANTECA Manteca [fn 104 <br /> ZIP code 95330 95336 (0re{ 105 <br /> Facility phone 916-373-3333 Same 102 <br /> Facility mailing address PO BOX 15618 1280 Lathrop Rd 108a <br /> SACRAMENTO, CA 95852 Manteca, CA 95336` 108b,10ec,108a <br /> BILLING INFORMATION <br /> Contact name RALEYS#311 GLENN BAKER 140 <br /> Address PO BOX 15618 500 WEST CAPITOL AVE 143 <br /> SACRAMENTO, CA 95852 WEST SACRAMENTO, CA 95605 144, 145, 146 <br /> Contact phone 916-373-3333 916-373-6318 141 <br /> Contact email gbaker@raleys.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP 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: Date: <br /> Accounting: Reviewed by Date: /�'� /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 /> 1619-RETAIL MKT>1000 So FT(=1>2 DEPTS) PRO162931 KADEANNE LINHARES Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PR0540566 NICHOLAS LOEHRER Active [ ] [ ] <br /> C,4� ao v'a C.4�2S <br />