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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 4/10/2018 <br /> Submitted on: 2/16/2018 8:45:23PM CERS ID: 10746523 <br /> Submitted by: Benny Dhanda Email: rahulsdhanda@gmail.com Facility ID in CERS: incorrect <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 OW0005079 <br /> Owner name PERHSING HOLDINGS INC Sarjiwan Singh 111 <br /> Mailing address 1732 BRANDON ST 35 10606 savoy circle 113 <br /> STOCKTON, CA 95209 stockton, CA 95209 114, 115, 116 <br /> Work phone 209-838-7579 2099921255 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000293 <br /> Facility name ARCO 83812 Pershing Holdings, Inc. DBA Esclon Arco 3 <br /> Site address 1329 S ESCALON AVE 1329 Escalon Ave 103 <br /> City ESCALON Escalon 104 <br /> ZIP code 95320 95320 105 <br /> Facility phone 209-838-7579 2098387579 102 <br /> Facility mailing address 1329 S ESCALON AVE 1329 Escalon Ave 1082 <br /> ESCALON, CA 95320 Escalon, CA 95320 1082, 108e,108d <br /> BILLING INFORMATION <br /> Contact name PERSHING HOLDINGS INC Sarjiwan Singh 140 <br /> Address 1329 S ESCALON AVE 1329 Escalon Ave 143 <br /> ESCALON, CA 95320 Escalon, CA 95320 144, 145, 146 <br /> Contact phone 510-364-8974 2099921255 141 <br /> Contact email mitchellcarwash@gmail.com 142 <br /> Mail invoices to Account <br /> Program record [ HMBP [ SQG HW [ ] LQG HW [ ] RCRA HW New PR#: Oq-W7 0'51A k'25 <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: 11G4 <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: ,­-\ f-\Z- Date: H-10-IQ <br /> Accounting: Reviewed by: Dater lg!I b Clerical: [ ] File j ] 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 /> 1617-RETAIL MARKET> 1000 SQ FT VV 1 FOOD PREP PRO542138 SCOTT SANGALANG Active [ ] [ ] <br /> 2351 -UST FACILITY-2481 COMPLIANT PR0231487/ JOHN ALANIZ Active [ ] [ ] <br /> 1616-RETAIL MARKET< 1000 SQ FT N!1 FOOD PREP PRO161635 SCOTT SANGALANG Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507241 ALISON YOOUNGBL�O'}OD Inactive <br /> pp [ ] [ ] <br />