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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 3/23/2015 <br /> Submitted on: 1/26/2015 3:38:57PM CERS ID: 10185165 <br /> Submitted by: Amy Martinez Email: amy.martinez@shawgrp.com Facility ID in CERS: FA0016413 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0013286 <br /> Owner name Lowe's HIW, Inc. Lowe's Home Centers, LLC 111 <br /> Mailing address 101 Andover Park E Ste 200 c/o Mailcode A: 101 Andover Park E Ste 200 c/o Mailcode A 113 <br /> Tukwila, WA 98188 Tukwila, WA 98188 114, 115, 116 <br /> Work phone 206-242-8570 (206) 242-8570 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016413 <br /> Facility name LOWE'S#1706 LOWE'S#1706 3 <br /> Site address 1389 S LOWER SACRAMENTO RD 1389 S LOWER SACRAMENTO RD 103 <br /> City LODI LODI 104 <br /> ZIP code 95242 95242 105 <br /> Facility phone 888-429-6281 (888)429-6281 102 <br /> Facility mailing address 1000 LOWE'S BLVD 1000 LOWE'S BLVD 108a <br /> MOORESVILLE, NC 28117 MOORESVILLE, NC 28117 108b,1o8c,m8d <br /> BILLING INFORMATION <br /> Contact name Rob Gass Rob Gass 140 <br /> Address 1000 LOWE'S BLVD. 1000 LOWE'S BLVD. 143 <br /> MOORESVILLE, NC 28117 MOORESVILLE, NC 28117 144, 145, 146 <br /> Contact phone 704-758-6033 (704) 758-6033 141 <br /> Contact email Robert.A.Gass@lowes.com Robert.A.Gass@lowes.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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: �'t^ Date: '13'I� <br /> - --- -- - - - -- - 3=-- ----- <br /> Accounting: Reviewed by: W) 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 /> 1921 -HMBP-Regular-Primary Location PR0524470 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0536647 MICHELLE HENRY Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534483 not assigned Inactive [ ] [ ] <br />