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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11/22/2017 <br /> Submitted on: 9/1412017 4:16:41AM CERS ID: 10643449 <br /> Submitted by: Lisa Bongiovanni Email: lisa.bongiovanni@rpsgroup.com Facility ID in CERS: incorrect <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 OW0022912 <br /> Owner name Medical Management International, Inc. DB/ Medical Management International, Inc. DBA B 111 <br /> Mailing address PO Box 87586 PO Box 87586 113 <br /> Vancouver, WA 98687 Vancouver, WA 98687 114, 115, 116 <br /> Work phone 866-894-7927 (866) 894-7927 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0024356 <br /> Facility name Banfield Pet Hospital#1164 Banfield Pet Hospital #1164 3 <br /> Site address 2477 Naglee Rd 2477 Naglee Rd 103 <br /> City Tracy Tracy 104 <br /> ZIP code 95304 95304 105 <br /> Facility phone 209-832-9373 209-832-9373 102 <br /> Facility mailing address 2477 Naglee Road 2477 Naglee Road 108a <br /> Tracy, CA 95304 Tracy, CA 95304 108b,108c, load <br /> BILLING INFORMATION <br /> Contact name Sean Akers Sean Akers 140 <br /> Address PO Box 87586 PO Box 87586 143 <br /> Vancouver, WA 98687 Vancouver, WA 98687 144, 145, 146 <br /> Contact phone 360-784-5217 (360) 784-5217 141 <br /> Contact email sean.akers@banfield.net sean.akers@banfield.net 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP SOG HW [ ] LQG HW [ ] RCRA HW New PR#: P/ 05'J Z 310 <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: 1_4- 2 <br /> Assigned to: V[�9-a.i �-. <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Jam �-- Date: <br /> Accounting: Reviewed by: Ise.? Date: JZ 1 IL 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 PRO542390 TWO VACANT2 Active [ ] ( � <br /> Irvc:trr-E I w,j Pt_4._1,? cis Per <br />