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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: 3/2/2017 9:11:01AM CERS ID: 104$6180 <br /> Submitted by: Susan Allen Email: susan_a]len@tjx.com Facility ID in CERS: FA0016567 <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 4. _ <br /> Owner ID OW0011850 MAyV D��1 <br /> Owner name TJ Maxx of CA, LLC Homegoods, Inc. <br /> Mailing address 770 Cochituate Road 770 Cochituate Road 113 <br /> Framingham, MA 01701 Framingham, MA 01701 114, 115, 116 <br /> Work phone 774-308-3651 774-308-3651 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FAC016567 <br /> Facility name Homegoods 0344 Homegoods 0344 3 <br /> Site address 5416 Pacific Ave 5416 Pacific Ave 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95207 95207 105 <br /> Facility phone 209-955-1750 (209)955-1750 102 <br /> Facility mailing address 770 Cochituate Road 770 Cochituate Road 108a <br /> Framingham, MA 01701 Framingham, MA 01701 108b lost 1084 <br /> BILLING INFORMATION <br /> Contact name Colleen Clark Colleen Clark 140 <br /> Address 770 Cochituate Road 300.2CN 770 Cochituate Road 300.2CN 143 <br /> Framingham, MA 01701 Framingham, MA 01701 144, 145 146 <br /> Contact phone 774-308-7625 774-308-7625 141 <br /> Contact email Colleen_Clark@tjx.com Colleen_Clark@,tjx.com 142 <br /> Mail invoices to Account <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: 00-n fes— Date: <br /> Accounting: Reviewed by: Date.- I j 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 /> 1620-RETAIL MKT 26-300 SQ FT(INCIDENTAL FOODS) PRO524668 MARIBEL FLQHRSCHUTZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO539291 VICKI MCCARTNEY Active [ ] [ ] <br /> ApivovA b .,[,,.r c,I.,,,,)e-. <br />