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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/11/2017 <br /> Submitted on: 1/6/2017 4:18:21 PM CERS ID: 10140229 <br /> Submitted by: Bryan Chen Email: Bryan.Chen@arcadis-us.com Facility ID in CERS: FA0013652 <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: 6 <br /> Owner ID OW0008345 <br /> Owner name The Home Depot U.S.A., Inc. The Home Depot U.S.A., Inc. 111 <br /> Mailing address 2455 Paces Ferry Rd, C-19 2455 Paces Ferry Rd, C-19 113 <br /> Atlanta, GA 30339 Atlanta, GA 30339 114, 115, 116 <br /> Work phone 770-433-8211 770-433-8211 x82714 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0013652 <br /> Facility name THE HOME DEPOT STORE#1022 THE HOME DEPOT STORE#1022 3 <br /> Site address 5010 FEATHER RIVER DR 5010 Feather River Dr 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95219 95219 105 <br /> Facility phone 209-474-8285 209-474-8285 102 <br /> Facility mailing address 5010 Feather River Drive 5010 Feather River Drive 108a <br /> Stockton, CA 95219 Stockton, CA 95219 108b, 1080,load <br /> BILLING INFORMATION <br /> Contact name Arcadis U.S., INC.-COMPLIANCE DEPT Arcadis U.S., INC. 140 <br /> Address 160 Chapel Road Suite 201 160 Chapel Road Suite 201 C/O Compliance 143 <br /> Manchester, CT 06042 Manchester, CT 06042 144, 145, 146 <br /> Contact phone 860-645-0184 860-645-0184 141 <br /> Contact email tierlladministrator@arcadis-us.com tieriladministrator@arcadis.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: a M Date: <br /> Accounting: Reviewed by: Date: //IyI/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 /> 1921 -HMBP-Regular-Primary Location 8 chem units PRO521 NO HAZA SAEED Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0518008 AARON HANG Active [ ] [ ] <br /> 1620-RETAIL MKT 26-300 SO FT(INCIDENTAL FOODS) PR0526582 VIDAL PEDRAZA Inactive [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0518009 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO518010 HAZ MAT SJC DES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534503 not assigned Inactive [ ] [ ] <br />