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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 10/21/201E <br />Submitted on: 10/21/2016 2:32:15PM <br />Submitted by: Joaquin Morales Email: chinastk209@gmail.com <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner: 1 <br />OW0021892 <br />MORALES-LOPEZ, JOAQUIN <br />902 S STANISLAUS ST <br />STOCKTON, CA 95206 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0023592 <br />Facility name <br />MORALES AUTO REPAIR <br />Site address <br />830 S CALIFORNIA ST <br />City <br />STOCKTON <br />ZIP code <br />95206 <br />Facility phone <br />209-271-5273 <br />Facility mailing address 902 S STANISLAUS ST <br />STOCKTON, CA 95206 <br />BILLING INFORMATION <br />Contact name MORALES AUTO REPAIR <br />Address 902 S STANISLAUS ST <br />STOCKTON, CA 95206 <br />Contact phone 209-271-5273 <br />Contact email <br />Mail invoices to Facility <br />CERS ID: 10707730 <br />Facility ID in CERS: incorrect <br />Information after CIW processing CERS <br />(current submittal) field <br />Joaquin Morales 111 <br />902 s stanislaus st 113 <br />Stockton, CA 95206 114, 115, 116 <br />2092715273 112 <br />Morales Auto Repair <br />3 <br />830 S California St <br />103 <br />Stockton <br />104 <br />95206 <br />105 <br />?2092715273 <br />102 <br />830 s. California st -- <br />108a <br />Stockton, CA 95206 <br />108b, 108c, 108d <br />Joaquin morales .- <br />140 <br />902 s stanislaus st <br />143 <br />Stockton, CA 95206 <br />144, 145, 146 <br />2092715273 -` <br />141 <br />chinastk209@gmail.com <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />New PE: _ <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this nlIdar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by:'vl Date: 2f I �up <br />Accounting: Reviewed by: Date: t D tl1* Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge 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 />1920 - HMBP-Common Materials PR0541192 ROBERT LOPEZ Active [ ] [ ] <br />2220 - SM HW GEN <5 TONSNR PR0541193 ONE VACANTI Active [ ] [ ] <br />lz- 10 <br />