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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to FnvisionConnect by CERS Integration Wizard <br /> Date run: 211112{}15 <br /> Submitted on: 111512015 12:14:15PM CERS ID: 10183583 <br /> Submitted by: skip chapin Email: skipchapin480@yahoo.com Facility ID in CERS: FA0010479 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008479 <br /> Owner name CROMER, MARSHALL marshall cromer 111 <br /> Mailing address 4701 OAKPORT ST 4701 oakport 113 <br /> OAKLAND, CA 94601 oakland, CA 94601 114, 115, 116 <br /> Work phone 209-465-8987 510-534-6566 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010479 <br /> Facility name CROMER MATERIAL HANDLING CROMER MATERIAL HANDLING 3 <br /> Site address 1813 MOFFAT BLVD 1813 MOFFAT BLVD 103 <br /> City MANTECA MANTECA 104 <br /> ZIP code 95336 95336 105 <br /> Facility phone 209-465-8987 510-534-6566 102 <br /> Facility mailing address 1813 MOFFAT BLVD 1813 moffat blvd 108a <br /> MANTECA, CA 95336 Manteca, CA 95336 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name CROMER MATERIAL HANDLING MARSHALL CROMER 140 <br /> Address 1813 MOFFAT BLVD 1813 MOFFAT BLVD 143 <br /> MANTECA, CA 95336 MANTECA, CA 95336 144, 145. 146 <br /> Contact phone Not Specified 510-534-6566 141 <br /> Contact email MCROMER@CROMER.COM 142 <br /> Mail invoices to -F_ai�iiity <br /> Program record [ ] HMBP [ ] SOG 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: 1)`J4`" Date: ���—I� <br /> Accounting: Reviewed by. Date: 3fi (L-11 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified I By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Reguiar-Primary Location PR0520376 MICHAEL PARISSI Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO517544 ELENA MANZO Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510479 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0526111 BENJAMIN ESCOTTO Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO531850 not assigned Inactive [ ] [ ] <br />