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F� SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/13/2017 <br /> Submitted on: 1/7/2017 5:26:39AM CERS ID: 10709518 <br /> Submitted by: Jim Monroe Email:jimmonro@amazon.com <br /> Facility ID in CERS: FA0023764 <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 OW0022098 <br /> Owner name Golden State FC LLC Golden State FC LLC 111 <br /> Mailing address 345 Boren Ave. N. 345 Boren Ave. N. 113 <br /> Seattle, WA 98109 Seattle, WA 98109 114, 115, 116 <br /> Work phone 206-435-2754 206.435.2754 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0023764 <br /> Facility name GOLDEN STATE FC LLC SJC7 Golden State FC, LLC (SJC7) 3 <br /> Site address 188 MOUNTAIN HOUSE PKWY 188 Mountain House Pkwy 103 <br /> City TRACY Tracy 104 <br /> ZIP code 95377 95377 105 <br /> Facility phone 209-740-8529 209.740.8529 102 <br /> Facility mailing address 188 Mountain Hoiuse Pkwy 188 Mountain Hoiuse Pkwy 108a <br /> Tracy, CA 95377 Tracy, CA 95377 10eb. 1015c,toad <br /> BILLING INFORMATION <br /> Contact name Lance Jones Lance Jones 140 <br /> Address 345 Boren Ave. N. 345 Boren Ave. N. 143 <br /> Seattle, WA 98109 Seattle, WA 98109 144, 145, 146 <br /> Contact phone 206-435-2754 206.435.2754 141 <br /> Contact email lancejon@amazon.com lancejon@amazon.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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: 111511-7 <br /> --- --- - --- -- - -- - - <br /> Accounting: Reviewed by: �fj Date: 1/1-7/1-7 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 /> 1921 -HMBP-Regular-Primary Location 25 chem units PRO541452 PETER LOMBARDI Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO541451 BETTY HO Active [ ] [ ] <br />