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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: 5/2/2014 9:22:41AM CERS ID: 10181237 <br /> Submitted by: Sandesh Bola Email: woodbridgeampm@yahoo.com Facility ID in CERS: FA0003607 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0002383 <br /> Owner name JASS ENTERPRISES INC JASS ENTERPRISES INC 111 <br /> Mailing address 18806 N LOWER SACRAMENTO RD 18806 N LOWER SACRAMENTO RD 113 <br /> WOODBRIDGE, CA 95258 WOODBRIDGE, CA 95258 114, 115,116 <br /> Work phone 209-339-8238 2093398238 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003607 <br /> Facility name WOODBRIDGE AM PM* WOODBRIDGE AM PM* 3 <br /> Site address 18806 N LOWER SACRAMENTO RD 18806 N LOWER SACRAMENTO RD 103 <br /> City Woodbridge WOODBRIDGE 104 <br /> Zip code 95258 95258 <br /> Facility phone 209-339-8238 (209) 339-8238 1 02 <br /> Facility mailing address 18806 N LOWER SACRAMENTO RD 18806 N LOWER SACRAMENTO RD 108a <br /> WOODBRIDGE, CA 95258 WOODBRIDGE, CA 95258 108b, 108c, toed <br /> BILLING INFORMATION <br /> Contact name WOODBRIDGE AM PM* WOODBRIDGE AM PM* 140 <br /> Address 18806 N LOWER SACRAMENTO RD 18806 N LOWER SACRAMENTO RD 143 <br /> WOODBRIDGE, CA 95258 WOODBRIDGE, CA 95258 144, 145, 146 <br /> Contact phone 209-339-8238 2093398238 141 <br /> Contact email 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: a I J� Date: (0 2 I I <br /> Accounting: Reviewed by: Date: [ ] File [ ] Relabel file [ ] Create new file <br /> --------------------------------- <br /> - tg1/ — Clerical:— <br /> [ ] Ac I led [ ] Surch veri led By: Date: <br /> --------- ------- <br /> ------------------ <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 PRO521113 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PRO517889 ARIS VELOSO Active [ ] [ ] <br /> 2301 -UST STATE SURCHARGE FEE PRO508285 Feline Zareef Inactive [ ] [ ] <br /> 2361 -UST FACILITY PRO232388 ARIS VELOSO Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507365 Fatina Zareef Inactive [ ] [ ] <br />