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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 3/31(2017 <br /> Submitted on: 3/27/2017 11:43:22AM CERS ID: 10184897 <br /> Submitted by: Scott Knutz Email: scott.w.knutz@lesschwab.com Facility ID in CERS: FA0015188 <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 OW0012485 <br /> Owner name LES SCHWAB TIRE CENTER Les Schwab Tire Centers of California, Inc. 111 <br /> Mailing address PO BOX 5350 PO BOX 5350 113 <br /> BEND, OR 97708-5350 BEND, OR 97708-5350 114. 115, 116 <br /> Work phone 541-416-5514 541-416-5514 112 <br /> FACILITY FILE INFORMATION <br /> Faciiity ID FA0015188 <br /> Facility name LES SCHWAB TIRE CENTER LES SCHWAB TIRE CENTER 3 <br /> Site address 615 E LODI AVE 615 E LODI AVE 103 <br /> City LODI LODI 104 <br /> ZIP code 95240 95240 105 <br /> Facility phone 209-334-3961 (209) 334-3961 102 <br /> Facility mailing address PO BOX 5350 PO BOX 5350 108a <br /> BEND, OR 97708-5350 BEND, OR 97708-5350 108b, 1oec,road <br /> BILLING INFORMATION <br /> Contact name Scott Knutz Cayce DaRosa 140 <br /> Address PO BOX 5350 631 Harbor Blvd. 143 <br /> BEND, OR 97708-5350 West Sacramento, CA 95691 144, 145, 146 <br /> Contact phone 541-416-5514 916-534-0841 141 <br /> Contact email scott.w.knutz@lesschwab.com cayce.e.darosa@fesschwab.corn 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG HW [ ] RCRA HW New PII <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ j full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: 00L-8r--- Date: -�[`]7 <br /> Accounting: Reviewed by: W Date.- 41q <br /> lr-7 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 2220-SM HW GEN<5 TONS/YR PR0523623 ONE VACANT1 Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0522296 ANGELICA SANCOVAL MAI Active [ ] [ <br /> 1921 -HMBP-Regular-Primary Location 2 chem units PRO528024 JAMIE LIMA Inactive [ ] [ <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE F1 PRO532497 not assigned Inactive [ ] [ ] <br />