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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Submitted on: 112312014 1:07:52PIM Date run: 6/21/2014 <br /> Submitted by: balaji angle Email: bsanglel@gmaii.com CERS ID: 10181381 <br /> Facility ID in CERS: FA0003753 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0005767 <br /> Owner name ANGLE, BALAJI S ANGLE, BALAJI S 111 <br /> Mailing address 35584 CONOVAN LN 35584 CONOVAN LN 113 <br /> FREMONT, CA 94536 FREMONT, CA 94536 114, 115, 116 <br /> Work phone 510-552-4822 (510) 552-4822 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003753 <br /> Facility name RIPON SHELL RIPON SHELL` 3 <br /> Site address 341 E MAIN ST 341 E MAIN ST 103 <br /> City RIPON RIPON 104 <br /> Zip code 95366 95366 105 <br /> Facility phone 209-599-4454 (209) 599-4454 102 <br /> Facility mailing address 341 E MAIN ST 341 E MAIN ST 108a <br /> RIPON, CA 95366 RIPON. CA 95366 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name RIPON SHELL RIPON SHELL* 140 <br /> Address 341 E MAIN ST 341 E MAIN ST 143 <br /> RIPON, CA 95366 RIPON, CA 95366 144, 145, 146 <br /> Contact phone Not Specified (209) 599-4454 141 <br /> Contact email bsanglel @gmaii.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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: AA Date: �-t•�� <br /> -------------- <br /> Accounting: Reviewed by: Date: .��l Clerical—/File [ ] Relabel file [ ] Create new file <br /> [ ] Ac illecl [ ] Surchargelerified J By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1615-RETAIL MKT 301-2000 SO FT(PREPKGD/LTD PREP; PRO161601 LISA MEDINA Active [ ] [ ] <br /> 1 1921 -HMBP-Regular-Primary Location PRO519348 MICHAEL PARISSI Active [ ] [ <br /> 2220-SM HW GEN<5 TONS/YR PRO518313 ELENA MANZO Active [ I [ ] <br /> 2361 -UST FACILITY PR0231477 ELENA MANZO Active [ ] ( ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0507439 ALISON YOUNGBLOOD Inactive [ ] ( J <br />