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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/21/2014 <br /> Submitted on: 5/2/2014 8:37:45AM CERS ID: 10181467 <br /> Submitted by: Charles Bittle Email: cbittle@chevron.com Facility ID in CERS: FA0003834 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0001987 <br /> Owner name CHEVRON PRODUCTS COMPANY(A DIVI CHEVRON PRODUCTS COMPANY(A DIVI 111 <br /> Mailing address P.O. BOX 6004, ATTN: PERMIT DESK P.O. BOX 6004, ATTN: PERMIT DESK 113 <br /> SAN RAMON, CA 94583 SAN RAMON, CA 94583 114, 115, 116 <br /> Work phone 925-842-9002 (925) 842-9002 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003834 <br /> Facility name CHEVRON STATION#96171* CHEVRON STATION#96171 3 <br /> Site address 6633 PACIFIC AVE 6633 PACIFIC AVE 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95207 95207 105 <br /> Facility phone 209-477-4294 (209) 477-4294 102 <br /> Facility mailing address PO BOX 6004/ 12375-B3 P.O. BOX 6004, ATTN: PERMIT DESK 108a <br /> SAN RAMON, CA 94583 SAN RAMON, CA 94583 108b, 1080,108d <br /> BILLING INFORMATION <br /> Contact name CHEVRON STATION #96171* CHEVRON PRODUCTS COMPANY(A DIVI 140 <br /> Address PO BOX 6004/ 1-2375-63 P.O. BOX 6004, ATTN: PERMIT DESK 143 <br /> SAN RAMON, CA 94583 SAN RAMON, CA 94583 144, 145, 146 <br /> Contact phone Not Specified (925) 842-9002 141 <br /> Contact email PERMITDESK@CHEVRON.COM 142 <br /> Mail invoices to Facility/ <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: .43 Date: to, <br /> Accounting: Reviewed by: _ Date: ly I Clerical: k/] File [ ] Relabel file [ ] Create new file <br /> [ ] Acc ed [ ] Surch a verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PRO520539 HAZA SAEED Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PR0514447 Fatina Zareef Active [ ] [ ] <br /> 2301 -UST STATE SURCHARGE FEE PR0507699 MICHAEL KITH Inactive [ ] [ ] <br /> 2361 -UST FACILITY PR0231784 Fatina Zareef Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507491 MICHAEL KITH Inactive [ ] [ ] <br /> 3123-STORMWATER INSPECTION-RETAIL GAS OUTLET PR0523006 GARRETT BACKUS Inactive [ ] [ ] <br />