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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 8:50:34AM CERS ID: 10181653 <br /> Submitted by: Charles Bittle Email: cbiftle@chevron.com Facility ID in CERS: FA0004521 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0001987 <br /> Owner name CHEVRON PRODUCTS COMPANY(A DTVI CHEVRON PRODUCTS COMPANY(A DIVI 111 <br /> Mailing address P.O. BOX 6004, ATTN: PERMIT DESK P.O. BOX 6004, ATTN: PERMIT DESK 113 <br /> SAN RAMON, CA 94583 SAN RAMON, CA 94583 114, 115, 116 <br /> Work phone 925-842-9002 (925) 842-9002 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0004521 <br /> Facility name CHEVRON USA#201761' CHEVRON USA#201761" 3 <br /> Site address 1103 S MAIN ST 1103 S MAIN ST 103 <br /> City MANTECA MANTECA 104 <br /> Zip code 95337 95337 105 <br /> Facility phone 209-825-0714 (209)825-0714 102 <br /> Facility mailing address PO BOX 6004/L2375-B3 P.O. BOX 6004, ATTN: PERMIT DESK 108a <br /> SAN RAMON, CA 94583 SAN RAMON, CA 94583 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name CHEVRON USA#201761 CHEVRON PRODUCTS COMPANY(A DIVI 140 <br /> Address PO BOX 6004/1-2375-B3 P.O. BOX 6004, ATTN: PERMIT DESK 143 <br /> SAN RAMON, CA 94583 SAN RAMON, CA 94583 144, 145, 146 <br /> Contact phone 209-825-0174 (925) 842-9002 141 <br /> Contact email PERMITDESK@CHEVRON.COM 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ) Tiered permit [ ] APSA [ ] CalARP [ j UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendarear <br /> y [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: b(Z'I 11 q- <br /> ------------------------------------- <br /> Accounting: Reviewed by:_W Date: —— — Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct 'led [ ] Surcharge fied By: Date: <br /> ------ <br /> ------------------------ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Pro ram Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PR0520225 MICHAEL PARISSI Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO514250 ELENA MANZO Active [ ] [ ] <br /> 2301 -UST STATE SURCHARGE FEE PR0507747 ALISON YOUNGBLOOD Inactive [ ] [ ] <br /> 2361 -UST FACILITY PR0232587 ELENA MANZO Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507582 ALISON YOUNGBLOOD Inactive [ ] [ ] <br />