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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 4/26/2018 <br /> Submitted on: 12/27/2017 10:38:59AM CERS ID: 10412521 <br /> Submitted by: Dale Patton Email: dale.patton@wincofoods.com Facility ID in CERS: FA0014185 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 2 <br /> Owner ID OW0011237 <br /> Owner name WinCo Foods LLC WinCo Foods LLC 111 <br /> Mailing address 650 N. Armstrong Place 650 N. Armstrong Place 113 <br /> Boise, ID 83704 Boise, ID 83704 114, 115, 116 <br /> Work phone 208-377-0110 208-377-0110 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0014185 <br /> Facility name WinCo Foods#10 WinCo Foods#10 3 <br /> Site address 5110 Montauban Ave 5110 Montauban Ave 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95210 95210 105 <br /> Facility phone 209-954-1360 209-954-1360 102 <br /> Facility mailing address PO BOX 5756 51 Mo auban Ave. Q 108a <br /> BOISE, ID 83705 Stoc n, CA 95210 t )) 108b,108c,1084 <br /> BILLING INFORMATION \�`I,n"]A�IJ <br /> Contact name WinCo Foods#10 nale Patto V nn ((�� 140 <br /> Address PO BOX 5756 N. strong Place fit/ 143 <br /> BOISE, ID 83705 Bol ID 83704 144, 145, 146 <br /> Contact phone 208-672-2054 2 -6 440 141 <br /> Contact email ale.patto wincofoods.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG H [ ] 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: lv� Date: <br /> Accounting: Reviewed by:tb Date: 5711, 1';r Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1619-RETAIL MKT>1000 SQ FT(=/>2 DEPTS) PRO518877 GEHANE FAHMY Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location 4 chem units PR0539335 JAMIE LIMA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO537677 VICKI MCCARTNEY Active [ ] [ ] <br />