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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />0urJmltted on: 7/17/2014 11:13:40AM <br />Submitted by: Ruben Lopez Email: mrrubenlopez@yahoo.com <br />Information prior to CIW processing <br />OWNER INFORMATION (current EC database) <br />Owner ID OW0007247 <br />Owner name LOPEZ, RUBEN & GARCIA, DAVID <br />Mailing address 3422 E MINER AVE <br />STOCKTON, CA 95205 <br />Work phone 209-323-5350 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0009247 <br />Facility name <br />B&H TRANSMISSION AUTO CARE <br />Site address <br />3422 E MINER AVE <br />City <br />STOCKTON <br />Zip code <br />95205 <br />Facility phone <br />209-323-5350 <br />Facility mailing address <br />3422 E MINER AVE <br />BILLING INFORMATION <br />Contact name <br />Address <br />Contact phone <br />Contact email <br />Mail invoices to <br />STOCKTON, CA 95205 <br />B&H TRANSMISSION AUTO CARE <br />3422 E MINER AVE <br />STOCKTON, CA 95205 <br />Not Specified <br />Facility <br />Date run: 7/31/2014 <br />CERS ID: 10182543 <br />Facility ID in CERS: FAD009247 <br />Information after CIW processing CERS <br />(current submittal) field <br />Ruben Lopez and David Garcia 111 <br />Carlton 113 <br />Stockton, 95203 114, 115, 116 <br />209-298-29595 9 112 <br />B&H TRANSMISSION AND AUTO CARE <br />140 <br />3422 E MINER AVE <br />3 <br />STOCKTON <br />103 <br />95205 <br />104 <br />209-323-5350 <br />105 <br />By: <br />102 <br />3422 E. Miner <br />108a <br />Stockton, CA 108b, 108c, load <br />Ruben Lopez and David Garcia .. <br />140 <br />3422 E. Miner <br />143 <br />Stockton, CA <br />144, 145, 146 <br />209-323-5350 <br />141 <br />File [ ] Relabel file [ ] Create new file <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST <br />New PR#: _ <br />New PE: _ <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] <br />next calendar year [ <br />] exempt from billing <br />Processed through CERS Integration Wizard by: �— Date: <br />,' 3I •t I <br />Accounting: Reviewed by: <br />U Date: Clerical: <br />File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified <br />By: <br />Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name <br />Status <br />Reactivated Inactivated <br />1920 - HMBP-Common Materials PRO521188 HAZA SAEED <br />Active <br />[ ] [ ] <br />2220 - SM HW GEN <5 TONSNR PRO513723 JEFFREY WONG <br />Active <br />[ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509247 HAZ MAT SJC DES <br />Inactive <br />[ ] [ ] <br />3122 - STORMWATER INSPECTION -AUTO SHOP PR0529446 JEFFREY WONG <br />Inactive <br />[ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PRO533008 not assigned <br />Inactive <br />[ ] [ ] <br />