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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 4/18/2017 <br /> Submitted on: 4/512017 10:46:36AM <br /> Submitted by; timothy clement Email: tmothyclement@gmail.com CERS ID: 10183967 <br /> Facility ID in CERS: FA0010944 <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: 1 <br /> Owner ID OW0008944 <br /> Owner name BROWN SAND INC Brown Sand INC 111 <br /> Mailing address PO BOX 1429 p.o. box 1429 113 <br /> LATHROP, CA 95330-1429 Lathrop, CA 95330 114, 115, 116 <br /> Work phone 209-234-1500 2092341500 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010944 <br /> Facility name BROWN SAND INC BROWN SAND INC 3 <br /> Site address 800 W MOSSDALE AVE 800 W MOSSDALE AVE 103 <br /> City LATHROP LATHROP 104 <br /> ZIP code 95330 95330 105 <br /> Facility phone 209-234-1500 2092341500 102 <br /> Facility mailing address PO BOX 1429 p.o.box1429 108a <br /> LATHROP, CA 95330-1429 lathrop, CA 95330 108b, 1080, 108d <br /> BILLING INFORMATION <br /> Contact name BROWN SAND INC Brown Sand INC 140 <br /> Address PO BOX 1429 P.O. box Iq,2`1 143 <br /> LATHROP, CA 95330-1429 Lathrop, CA 95330 144. 145 146 <br /> Contact phone 209-234-1500 2092341500 _ 141 <br /> Contact email 44iothyodement@gmail.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#. <br /> created [ ] Tiered permit j ] 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: OOr-. Date: <br /> Accounting: Reviewed by: _(1% Date: 1) Clerical: [ ] File [ ) Relabel file [ ] Create new file <br /> [ l Aartbillecl By: Date.- <br /> ACTIVE <br /> ate:ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 6 chem unify PRO520566 NfCHOLAS LOEHRER Active [ ] [ ] <br /> 2220-SM HW GEN <5 TONS/YR PRO514467 ROBERT KOSANOUVONG Active [ ] [ ] <br /> 2532-AST FAC 10 K-<J=100 K GAL CUMULATIVE PRO515783 ROBERT KOSANOUVONG .Active [ ] ( ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0513232 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2332-EXEMPT TANK FACILITY PR0530739 JOHNALANIZ Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510944 HAZ MAT SJC OFS Inactive [ 1 [ 1 <br /> ERSC-ELECTRONIC REPORTING STATE <br /> -�SURCHARGE F1 PR0532847 not assigned Inactive n <br /> Qei"kLoy.- - 8���+i.� � S�lvr1�t vL Litr(�L�e& %Aj �rk/L LL'(t5 - irr A- <br />