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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 5/11/2017 <br /> Submitted on: 5/3/2017 9:11:33AM CERS ID: 10505809 <br /> Submitted by: Ashley Campbell Email: Ashley.Campbell@stericycle.com Facility ID in CERS: FA0002178 <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: 8 <br /> Owner ID OW0001693 <br /> Owner name ROSS DRESS FOR LESS, INC Ross Dress For Less Inc. 111 <br /> Mailing address 5130 HACIENDA DRIVE 5130 Hacienda Dr 113 <br /> DUBLIN, CA 94568 Dublin, CA 94568-7579 114, 115, 116 <br /> Work phone 925-965-4526 925-965-4831 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0002178 <br /> Facility name ROSS DRESS FOR LESS#0035 Ross Dress For Less#0035 3 <br /> Site address 5756 PACIFIC AVE STE 60 5756 Pacific Ave Ste 60 103 <br /> City STOCKTON Stockton 104 <br /> ZIP code 95207 95207 105 <br /> Facility phone 209-957-6202 209-957-6202 102 <br /> Facility mailing address 5130 Hacienda Dr 5130 Hacienda Dr 108a <br /> Dublin, CA 94568-7579 Dublin, CA 94568-7579 108b,108c,1084 <br /> BILLING INFORMATION <br /> Contact name ROSS DRESS FOR LESS#0035 KATHY HATCH/LICENSING DEPT 140 <br /> Address 5130 Hacienda Dr 5130 Hacienda Dr 143 <br /> Dublin, CA 94568-7579 Dublin, CA 94568-7579 144, 145, 146 <br /> Contact phone Not Specified 925-965-4526 141 <br /> Contact email LICENSING@ROS.COM 142 <br /> Mail invoices to Account <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: 00 v' �— Date: 5-1(—(7 <br /> Accounting: Reviewed by: Date: 511510 7 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 /> 1615-RETAIL MKT 301-2000 SQ FT(PREPKGD/LTD PREP; PRO163334 MARIBEL FLOHRSCHUTZ Active [ ] [ ]/ <br /> 1920-HMBP-Common Materials 8 chem units PR0541791 JAMIE LIMA Active <br /> 2220-SM HW GEN<5 TONS/YR PRO539592 VICKI MCCARTNEY Active [ ] [ ] <br /> k��w <br />