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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run:4/8/2015 <br /> Submitted on: 3/27/2015 8:31:55AM CERS ID: 10181211 <br /> Submitted by: Mike Birkett Email: mbirkett@foodliner.com Facility ID in CERS: FA0003541 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0019882 <br /> Owner name Foodliner, Inc. Foodliner, Inc. 111 <br /> Mailing address 2099 Southpark Court, Suite 1 2099 Southpark Court, Suite 1 113 <br /> Dubuque, IA 52003 Dubuque, ]A 52003 114, 115, 116 <br /> Work phone 563-584-2672 563-584-2672 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0022456 <br /> Facility name Foodliner, Inc. Foodliner, Inc. 3 <br /> Site address 2431 E MARIPOSA RD 2467 E Mariposa Rd 103 <br /> City STOCKTON Stockton 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-941-8361 209-941-8361 102 <br /> Facility mailing address 2099 Southpark Court, Suite 1 2099 Southpark Court, Suite 1 108a <br /> Dubuque, ]A 52003 Dubuque, IA 52003 108b, 1080,1084 <br /> BILLING INFORMATION <br /> Contact name Mike Birkett Mike Birkett 140 <br /> Address 2099 Southpark Court, Suite 1 2099 Southpark Court, Suite 1 143 <br /> Dubuque, IA 52003 Dubuque, IA 52003 144, 145, 146 <br /> Contact phone 563-584-2672 563-584-2672 141 <br /> Contact email mbirkett@foodliner.com mbirkett@foodliner.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 calendarear <br /> y [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: UA) Date: L4 ' '[ <br /> -------------------------------------------------- <br /> Accounting: <br /> ------------------- ---------- -- --- - <br /> Accounting: Reviewed by:U_Date: 4113 i<' 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 /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PRO519468 ROBERT LOPEZ Active [ ] [ ] <br /> 2227-GEN 5<25 TONS PERMIT PRO513705 STACY RIVERA Active [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PRO528562 STACY RIVERA Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0523530 HARPRIT MATTU Active [ ] [ ] <br /> 2361 -UST FACILITY PR0231818 STACY RIVERA Inactive [ ] [ ] <br /> 2361-UST FACILITY PRO539714 ELENA MANZO Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507346 LETITIA BRIGGS Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532596 not assigned Inactive [ ] [ ] <br /> M/}1ef' ' ANY-'C- QV-k- ;v ptt"'O'q Pic <br /> i (-i�� Nra R aAT' i� awl 3-21 ,15 <br />