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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 7/9/2014 <br /> Submitted on: 1/21/2014 10:12:30AM CERS ID: 10412521 <br /> Submitted by: Dale Patton Email: dale.patton@wincofoods.com Facility ID in CERS: <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0011237 <br /> Owner name WINCO FOODS LLC WinCo Foods LLC 111 <br /> Mailing address PO BOX 5756 650 N. Armstrong Place 113 <br /> BOISE, ID 83705 Boise, ID 83704 114, 115,116 <br /> Work phone 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 S 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 <br /> 102 <br /> Facility mailing address PO BOX 5756 5110 Montauban Ave. 108a <br /> BOISE, ID 83705 Stockton, CA 95210 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name WINCO FOODS#10 Gina Crowley 140 <br /> Address PO BOX 5756 650 N. Armstrong Place 143 <br /> BOISE, ID 83705 Boise, ID 83704 144, 145, 146 <br /> Contact phone 209-954-1360 208-672-2346 141 <br /> Contact emailgina.crowley@wincofoods.com 142 <br /> Mail invoices to T"'�' r/r( <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: Date: <br /> Accounting: Reviewed by: A Date: I P111 Clerical: [ ] File [ ] Relabel Tile [ ] Create new file <br /> [ ] Acct [ ] Surch er le -------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 /> 1619-RETAIL MKT>1000 SO FT(=/>2 DEPTS) PR0518877 STEPHANIE RAMIREZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO637677 Fatina Zareef Active [ ] [ ] <br />