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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Changes to EnvisionConnect by CERS Integration Wizard Submitted on: 1/15/2015 8:45:41PM Date D: 1011/2015 47 Submitted by: Regina Metzker Email: rmetzker@kpaonline.com CERS ID: FA0010 24 Facility ID in CERS: FA0010424 Information prior to CIW processing Information after CIW processing CERS OWNER INFORMATION (current EC database) (current submittal) field Owner ID OW0008424 Owner name JOHN W CHASE JOHN W CHASE Mailing address PO BOX 8349 PO BOX 8349 111 STOCKTON, CA 95208 STOCKTON, CA 95208 114, 1153116 Work phone 209-475-6600 209-475-6600 112 FACILITY FILE INFORMATION Facility ID FA0010424 Facility name CHASE CHEVROLET CHASE CHEVROLET Site address 6441 HOLMAN RD 6441 HOLMAN RD 3 City STOCKTON 6441 HOLM 103 ZIP code 95212 STOCKTON Facility phone 209-475-6600 95212 105 (209)475-6600 102 Facility mailing address PO BOX 8349 PO BOX 8349 STOCKTON, CA 95208STOCKTON, CA 95208 108b,i�aaio8d BILLING INFORMATION Contact name CHASE CHEVROLET MELANIE SATTERFIELD Address PO BOX 8349 / PO BOX 8349 140 STOCKTON, CA 95208143 / STOCKTON, CA 95208 144, 1 5146 Contact phone 209-475-6600 209-475-6600 Contact email 141 Mail invoices to msatt@chasechevrolet.com 142 Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: created [ ] Tiered permit [ ] APSACalARP [ 1 [ ] UST New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing Processed through CERS Integration Wizard by: Date: ---------------- ____________ Accounting: Reviewed by: /� Date: M1'/1. Clerical: [ ] File [ ] Relabel file [ ] Create new file [ ] Acct billed [ ] Surcharge verified y _ B : Date: -- ------------ --- ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Program Element and Description Record ID Employee name Status Reactivated Inactivated 1921 -HMBP-Regular-Primary Location PRO520311 HAZA SAEED Active [ ] [ ] 2229-GEN 50<250 TONS PERMIT PRO514322 FATINAH ZAREEF Active [ ] [ ] 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PRO528222 FATINAH ZAREEF Active [ ] [ ] 4740-WASTE TIRE SITE-EXEMPT PR0522795 HARPRIT MATTU Active [ ] [ ] 2332-EXEMPT TANK FACILITY PRO535041 FATINAH ZAREEF Active, Exempt [ ] [ ] 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510424 HAZ MAT SJC OES Inactive [ ] [ ] ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO531261 not assigned Inactive [ ] [ ]