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SAN JOAQUIY"OOUNTY ENVIRONMENTAL HEALTFI%nEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 8/5/2014 <br /> Submitted on: 6/19/2014 10:10:27AM CERS ID: 10184063 <br /> Submitted by: tony webb Email: tony.webb@terex.com Facility ID in CERS: FA0011047 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0009047 <br /> Owner name TEREX UTILITIES INC TEREX UTILITIES INC 111 <br /> Mailing address 18465 NE 86TH ST 200 Nyala Farms RD. 113 <br /> REDMOND, WA 98052 Westport, CT 06880-6261 114, 115,116 <br /> Work phone 425-881-1800 (425) 881-1800 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0011047 <br /> Facility name TEREX UTILITIES INC TEREX UTILITIES INC 3 <br /> Site address 2610 LYCOMING ST 2610 LYCOMING ST 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95206 95206 105 <br /> Facility phone 800-536-1800 (800) 536-1800 102 <br /> Facility mailing address 18465 NE 86TH ST 18465 NE 86TH ST 108a <br /> REDMOND, WA 98052 REDMOND, WA 98052 108b,108c,coed <br /> BILLING INFORMATION <br /> Contact name TEREX UTILITIES INC TEREX UTILITIES INC 140 <br /> Address 18465 NE 86TH ST 18465 NE 86TH ST 143 <br /> REDMOND, WA 98052 REDMOND, WA 98052 144, 145, 146 <br /> Contact phone 425-881-1800 (425) 881-1800 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 ye*rorate thisscalendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Uvi Date: <br /> Accounting: Reviewed by:. �Date: Q '3 Clerical: File [ ] Relabel file [ ] Create new file <br /> [ ] Acettilled [ ] Surch--------------------------------— erified—— ——_ —_ —_ 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 PRO520632 ROBERT LOPEZ Active [ ] [ ] <br /> _-2a26-eSM HW GEN<5 TONS/YR 1.2.4-7 PR0518015 STACY RIVERA Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO511047 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0536443 ALFONSO ARAMBULA Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0536330 HAZ MAT SJC DES Inactive [ ] [ ] <br />