Laserfiche WebLink
SAN JOAQUI COUNTY ENVIRONMENTAL HEALT EPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 3/4/2015 <br /> Submitted on: 1/15/2015 1:21:35PM CERS ID: 10185055 <br /> Submitted by: JERRY DAVIS Email: JDAVIS@NACOMPOSITES.COM Facility ID in CERS: FA0015889 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0012810 <br /> Owner name JERRY D DAVIS JERRY D DAVIS 111 <br /> Mailing address 300 APOLLO DRIVE 300 APOLLO DRIVE 113 <br /> LINO LAKES, MN 55014 LINO LAKES, MN 55014 114, 115, 116 <br /> Work phone 651-766-5485 (651) 766-5485 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015889 <br /> Facility name NORTH AMERICAN COMPOSITES COMP/ NORTH AMERICAN COMPOSITES COMP/ 3 <br /> Site address 611 GILMORE AVE 611 GILMORE AVE BLDG 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95203 95203 105 <br /> Facility phone 209-932-0396 (209) 932-0396 102 <br /> Facility mailing address 300 APOLLO DRIVE 300 APOLLO DRIVE 108a <br /> LINO LAKES, MN 55014 LINO LAKES, MN 55014 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name JERRY D DAVIS JERRY D DAVIS 140 <br /> Address 300 APOLLO DRIVE 300 APOLLO DRIVE 143 <br /> LINO LAKES, MN 55014 LINO LAKES, MN 55014 144, 145, 146 <br /> Contact phone 651-766-5485 (651) 766-5485 141 <br /> Contact email JDAVIS@NACOMPOSITES.COM JDAVIS a@NACOMPOSITES.COM 142 <br /> Mall Invoices to - --- /- <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. OL' Date: <br /> Accounting: Reviewed by: _'C Date: �✓ Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> - ------------ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMP-Regular-Primary Location PR0523510 ROBERT LOPEZ Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO534291 not assigned Inactive [ ] [ ] <br />