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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 4/25/2018 <br /> Submitted on: 2/12/2018 8:10:45AM CERS ID: 10411684 <br /> Submitted by: Dale Patton Email: dale.patton@wincofoods.com Facility ID in CERS: FA0020585 <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: 2 <br /> Owner ID OW0011237 <br /> Owner name WinCo Foods LLC WinCo Foods LLC 111 <br /> Mailing address PO BOX 5756 650 N. Armstrong Place 113 <br /> BOISE, ID 83705 Boise, ID 83704 114, 115, 116 <br /> Work phone 208-377-0110 208-377-0110 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0020585 <br /> Facility name WinCo Foods#103 WinCo Foods#103 3 <br /> Site address 2850 Pavilion Pkwy 2850 Pavilion Pkwy 103 <br /> City Tracy Tracy 104 <br /> ZIP code 95304 95304 105 <br /> Facility phone 209-833-7454 209-833-7454 102 <br /> Facility mailing address PO BOX 5756 2850 vi" n Parkway 1V 108a <br /> BOISE, ID 83705 Tracy, C 95304 �n 108b tu8c,108d <br /> BILLING INFORMATION / U D 1P <br /> Contact name WinCo Foods#103 D Pat tP"}✓ 140 <br /> Address PO BOX 5756 650 rmstrong Place 143 <br /> BOISE, ID 83705 Boi 83704 �}� 144, 145, 146 <br /> Contact phone 208-672-2440 /20 -672- 0 141 <br /> Contact email .patton wincofoods.comv 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: r�bv'� �� Date: <br /> -- -- --- — -- --- — ---------- -- - <br /> Accounting- Reviewed by: Date: 61111T 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 /> 1619-RETAIL MKT>1000 SQ FT(=/>2 DEPTS) PRO535710 KADEANNE LINHARES Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location 3 chem units PR0539334v NICHOLAS LOEHRER Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0537676 TWO VACANT2 Active [ ] [ ] <br />