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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/11/2017 <br /> Submitted on: 1/9/2017 10:51:47AM CERS ID: 10148977 <br /> Submitted by: Kathleen Beresh Email: kathleen.beresh@cbi.com Facility ID in CERS: FA0000854 <br /> Information prior to CM processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 14 <br /> Owner ID OW0000596 <br /> Owner name Walmart Stores, Inc. Walmart Stores, Inc. 111 <br /> Mailing address 702 Southwest 8th Street 702 Southwest 8th Street 113 <br /> Bentonville, AR 72716-0500 Bentonville, AR 72716-0500 114, 115,116 <br /> Work phone 479-204-3911 (479) 204-3911 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000854 <br /> Facility name Walmart#1840 Walmart#1840 3 <br /> Site address 1205 S Main St 1205 S Main St 103 <br /> City Manteca Manteca 104 <br /> ZIP code 95337 95337 105 <br /> Facility phone 209-824-2000 (209)824-2000 102 <br /> Facility mailing address 702 Southwest 8th Street 702 Southwest 8th Street 108a <br /> Bentonville, AR 72716-0500 Bentonville, AR 72716-0500 108b,108c,10ed <br /> BILLING INFORMATION <br /> Contact name Shaw Env Inc (A CB&I Company) Shaw Environmental, Inc.(A CB&I Company 140 <br /> Address 11206 Thompson Avenue 11206 Thompson Avenue 143 <br /> Lenexa, KS 66219 Lenexa, KS 66219 144, 145, 146 <br /> Contact phone 877-829-5505 (877) 829-5505 141 <br /> Contact email walmartepmsupport@cbi.com walmartepmsupport@cbi.com 142 <br /> Mail invoices to Account <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 year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: A"f'Id�Date:-1/1/1.7 — <br /> Accounting: Reviewed by: Lt°J Date: 'h;-1!'] Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> -- — — ------- -------- -------- ----- - <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 14 chem units J JJ PR0527162 PETER LOMBARDI Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO516654 ROBERT KOSANOUVONG Active [ ] [ ] <br /> 2213-HAZ WASTE CE FAC STATE SURCHARGE FEE PR0506933 ALISON YOUNGBLOOD Inactive [ ] [ ] <br /> 2233-HAZARDOUS WASTE CESQT FACILITY PRO506932 ALISON YOUNGBLOOD Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO506934 ALISON YOUNGBLOOD Inactive <br /> 4740-WASTE TIRE SITE-EXEMPT PRO522836 ALFONSO ARAMBULA Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO533920 not assigned Inactive <br />