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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 3/2/2018 <br /> Submitted on: 1211/2017 9:31:48AM CERS ID: 10187549 <br /> Submitted by: Margaret Delph Email: margaret.delph@unifac.com Facility ID in CERS: FA0020243 <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: 2 <br /> Owner ID OW0009059 <br /> Owner name UNITED FACILITIES INC UNITED FACILITIES INC 111 <br /> Mailing address PO BOX 1387 PO BOX 1387 113 <br /> MANTECA, CA 95336-1147 MANTECA, CA 95336-1147 114, 115, 116 <br /> Work phone 309-699-7271 309-699-7271 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0020243 <br /> Facility name UNITED FACILITIES UNITED FACILITIES 3 <br /> Site address 4718 NEWCASTLE RD 4718 NEWCASTLE RD 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95215 95215 105 <br /> Facility phone 209-547-8040 (209) 647-8040 102 <br /> Facility mailing address PO BOX 559 PO BOX 1387 108a <br /> PEORI 651-0559 MANTECA, CA 95336-1147 108b, 108 , 1osd <br /> BILLING INFORMATION <br /> Contact nam UNITED FACILITIES UNIT D FAC IES 140 <br /> Addie s PO BOK 559 POB 7 143 <br /> PEORIA, IL 61651-0559 MANT A, CA 95336-1147 144, 145, 146 <br /> Contact ph ne Not Specified 309- 9- 71 141 <br /> Contact e it 142 <br /> Mail invoices Acco <br /> Program record [ ] HMBP [vrSQG HW [ ] LQG HW [ ] RCRA HW New PR#: 1`)'09-A,7-' I( <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: � <br /> Assigned to: Fto:-"lo <br /> Please bill: ( ] full calendar year [ ] prorate this calendar year [ ] next calendar year ( ] exempt from billing <br /> Processed through CERS Integration Wizard by: j ` Date: ; <br /> -- - ------- ------- ----- ---- - -------- ------ <br /> Accounting: Rev' wed by: _ Date: 2 I g Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [Acct billed 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 2 chem units PR0535951 1 JAMIE LIMA Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO535003 HARPRIT MATTU Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO536022 not assigned Inactive [ ] [ ] <br />