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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date11/28/2016 <br /> Submitted on: 11/23/2016 9:30:48AM <br /> CERS ID: 10711729 <br /> Submitted by: Jack Cao Email: maikhidoma@yahoo.com <br /> 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 OW0012300 <br /> Owner name CAO, JACK Jack Cao 111 <br /> Mailing address 8814 FOX CREEK DR 3230 E Main St 113 <br /> STOCKTON, CA 95210 Stockton, CA 95205 114, 115, 116 <br /> Work phone 209-922-4577 209 9224577 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0022074 <br /> Facility name N'S AUTO REPAIR N's AUTO REPAIR 3 <br /> Site address 3230 E MAIN ST 3230 E Main St 103 <br /> City STOCKTON Stockton 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-949-2553 209 9492553 102 <br /> Facility mailing address 8814 FOX CREEK DR 3230 E Main St 108a <br /> STOCKTON, CA 95210 Stockton, CA 95205 108b, 108c 108d <br /> BILLING INFORMATION <br /> Contact name N'S AUTO REPAIR Jack Cao 140 <br /> Address 8814 FOX CREEK DR 3230 E Main St 143 <br /> STOCKTON, CA 95210 Stockton, CA 95205 144, 145, 146 <br /> Contact phone 209-922-4577 209 9492553 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 year [ ] prorate this calendar year [ ] next calendarear <br /> y [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: 'J1 Date: [' <br /> Accounting: Reviewed by: Date: f 13Dll L Clerical: [ J FileRelabel file <br /> [ ] [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1920-HMBP-Common Materials PRO541323 HAZA SAEED Active ( I [ ] <br /> 2220-SM HW GEN<5 TONSNR PRO541324 TIMOTHY ENGLE Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO538200 ALFONSO ARAMBILLA Inactive [ ] [ ] <br />