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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/19/2014 <br /> Submitted on: 5/12/2014 1:34:07PM CERS ID: 10174699 <br /> Submitted by: Laura Payne Email: laura.payne@cbi.com Facility ID in CERS: FA0001227 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000596 <br /> Owner name Wal-Mart 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 FA0001227 <br /> Facility name Walmart#3022 Walmart#3022 3 <br /> Site address 1189 E March Ln 1189 E March Ln 103 <br /> City Stockton Stockton 104 <br /> Zip code 95210 95210 105 <br /> Facility phone 209-235-2047 (209)235-2047 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,108d <br /> BILLING INFORMATION <br /> Contact name Shaw Environmental, Inc., Attn: Licensing Si 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@shawgrp.com walmartepmsupport@shawgrp.com 142 <br /> Mail invoices to O>nr�r 1t/ <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: W{V Date: (P' l <br /> Accounting: Reviewed by: Date: ? ( Clerical: �,/f File [ ] Relabel file [ ] Create new file <br /> [ ] Ac——ed_ [ ] Surch — erified —By._ Date_— <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> d 1619-RETAIL MKT>1000 SQ FT(=h2 DEPTS) PR0162795 STEPHANIE RAMIREZ Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PRO537981 LOWELLALLEN Active I ] [ ] <br /> 2220-SM HW GEN E5 TONS/YR PR0537980 GARRETT BACKUS Active [ ] [ ] <br /> efP f <br />