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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6121/2014 <br /> Submitted on: 3112/2014 8:06:58AM CERS ID: 10181369 <br /> Submitted by: Chauncey Centeno Email: canepaslubeandoil@att.net <br /> Facility ID in CERS: FA0003743 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000629 <br /> Owner name Marion Canepa CANEPA, REMO J 111 <br /> Mailing address 642 N HUNTER ST 642 N HUNTER ST 113 <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 114, 115, 116 <br /> Work phone 209-465-6114 209-478-5515 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003743 <br /> Facility name CANEPAS LUBE & OIL CANEPAS LUBE & OIL 3 <br /> Site address 6220 PACIFIC AVE 6220 PACIFIC AVE 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95207 95207 105 <br /> Facility phone 209-951-9772 (209) 951-9772 102 <br /> Facility mailing address 6220 PACIFIC AVE 6220 PACIFIC AVE 108a <br /> STOCKTON. CA 95207 STOCKTON, CA 95207 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name CANEPAS LUBE & OIL CANEPAS LUBE & OIL 140 <br /> Address 6220 PACIFIC AVE 6220 PAC IFIC AVE 143 <br /> STOCKTON, CA 95207 STOCKTON, CA 95207 144, 145, 146 <br /> Contact phone 209-952-0606 209-478-5515 141 <br /> Contact email 142 <br /> Mail invoices to Facility ✓ <br /> Program record [ ] HMBP [ ] SQG HW [ ] LCIG 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 /> 1 <br /> Processed through CERS Integration Wizard by: 'xA Date: <br /> Accounting: Reviewed by: Date: Clerical: File [ ] Relabel file [ ] Create new file <br /> A billed Surchar ve Ifie— <br /> [ ] [ ] � By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1920-HMBP-Common Materials PRO519739 HAZA SAEED Active ( ] [ ] <br /> 2228-GEN 25<50 TONS PERMIT PRO513910 Fatina Zareef Active [ ] [ ] <br /> 2332-EXEMPT TANK FACILITY PR0231224 Fatina Zareef Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0507432 MICHAEL KITH Inactive [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0528058 GARRETT BACKUS Active, Exempt [ ] [ <br />