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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 8!8/2018 <br /> Submitted on: 1/9/2018 12:52:33PM CERS ID: 10187529 <br /> Submitted by: Paul Ferreira Email: paul.ferreira@yara.com Facility ID in CERS: FA0020111 <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: 1 <br /> Owner ID OW0016512 <br /> Owner name YARA NORTH AMERICA YARA NORTH AMERICA 111 <br /> Mailing address PO BOX 24926 100 North Tampa Street 113 <br /> TAMPA, FL 33623 TAMPA, FL 33602 114, 115, 116 <br /> Work phone 209-462-8094 (209)462-8094 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0020111 <br /> Facility name YARA NORTH AMERICA YARA NORTH AMERICA 3 <br /> Site address 312 LUCE AVE 312 LUCE AVE 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95203 95203 105 <br /> Facility phone 209-462-8094 (209)462-8094 102 <br /> Facility mailing address PO BOX 24926 212 Luce Ave. 108a <br /> TAMPA, FL 33623 Stockton, CA 95203 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name Shelby Nelson Shelby Nelson 140 <br /> Address PO Box 24926 PO Box 24926 143 <br /> Tampa, FL 33623-4926 Tampa, FL 33623-4926 144, 145, 146 <br /> Contact phone 813-222-5738 (813) 222-5738 141 <br /> Contact email Shelby.Nelson@Yara.com Shelby.Nelson@Yara.com 142 <br /> Mail invoices to Account <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: 1 Date: <br /> Accounting: Reviewed by: VZ? Date: 0/10 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 /> 1921 -HMBP-Regular-Primary Location 16 chem units PR0531225 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PR0539198 STACY RIVERA Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533467 not assigned Inactive [ ] [ ] <br />