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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/21/2014 <br /> Submitted on: 1/2912014 10:20:45AM CERS ID: 10181421 <br /> Submitted by: Jarnail Kamboj Email: twoguysfoodfuel@gmail.com Facility ID in CERS: FA0003789 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000141 <br /> Owner name CARDOZA, ED & DOLORES CARDOZA, ED & DOLORES 111 <br /> Mailing address 147 E LATHROP RD 147 E LATHROP RD 113 <br /> LATHROP, CA 95330 LATHROP, CA 95330 114, 115, 116 <br /> Work phone 209-239-4141 (209) 239-4141 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003789 <br /> Facility name TWO GUYS FOOD & FUEL TWO GUYS FOOD & FUEL 3 <br /> Site address 147 E LATHROP RD 147 E LATHROP RD 103 <br /> City Lathrop LATHROP 104 <br /> Zip code 95330 95330 105 <br /> Facility phone 209-858-2666 (209) 858-2666 102 <br /> Facility mailing address 147 E LATHROP RD 147 E LATHROP RD 108a <br /> LATHROP, CA 95330 LATHROP, CA 95330 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name TWO GUYS FOOD & FUEL TWO GUYS FOOD & FUEL 140 <br /> Address 147 E LATHROP RD 147 E LATHROP RD 143 <br /> LATHROP, CA 95330 LATHROP, CA 95330 144, 145, 146 <br /> Contact phone 209-858-2666 (209) 858-2666 141 <br /> Contact email TWOGUYSFOODFUEL@GMAIL.COM TWOGUYSFOODFUEL@GMAIL.COM 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: Date: <br /> Accounting: Reviewed b : Dake: r< Clerical: X File [ ] Relabel file [ ] Create new file <br /> [ ] Acc illed [ ] Surch 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 /> 1920-HMBP-Common Materials PRO520486 MICHAEL PARISSI Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0518130 THUY TRAN Active [ ] [ ] <br /> 2301 -UST STATE SURCHARGE FEE PR0507728 ALISON YOUNGBLOOD Inactive [ ] [ ] <br /> 2361 -UST FACILITY PR0232353 THUY TRAIN Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507465 ALISON YOUNGBLOOD Inactive [ ] [ ] <br />