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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to Envisioi-Connect by CERS Integration Wizard Date run: 10/28/2016 <br /> Submitted on: 10/27/2016 7:47:45AM CERS ID: 10138541 <br /> Submitted by: John Pallen Email:john.pallen@simplot.com Facility ID in CERS: FA0010287 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittall field <br /> Number of Facilities for this Owner: 1 <br /> Owner ID OW0008287 <br /> Owner name Steve Giannecchini Thompson Ranch 111 <br /> Mailing address PO Box10 7603 S. Jack Tone Road 113 <br /> Linden, CA 95236 Stockton, CA 95215 114, 115, 116 <br /> Work phone 209-931-1571 209 943-0774 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010287 <br /> Facility name SGS Stockton -Jack Tone Road SGS Stockton - Jack Tone Road 3 <br /> Site address 7707 JACK TONE RD 7707 Jack Tone Road 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95215 95215 105 <br /> Facility phone 209-461-6565 209 461-6565 102 <br /> Facility mailing address 7707 S Jack Tone Road 4863 Carpenter Road 108a <br /> Stockton, CA 95215 Stockton, CA 95215 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name Steve deArrillaga Jr Steve deArrillaga Jr 140 <br /> Address 7707 S Jacktone Road 4863 Carpenter Road 143 <br /> Stockton, CA 95215 Stockton, CA 95215 144, 145, 146 <br /> Contact phone 209-461-6565 209-941-4456 141 <br /> Contact email steve.dearrillaga@simplot.com steve.dearrillaga@simplot.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: Date: [o12g)JIV — — — —— — <br /> Accounting: Reviewed by: t46 Date: ID h% ]l li 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 /> 1921 -HMBP-Regular-Primary Location PRO521174 NICHOLAS LOEHRER Active [ ] CKl <br /> 2220-SM HW GEN<5 TONS/YR PR0538425 THREE VACANT3 Active [ ] Pq <br /> 1862-CaIARP PROGRAM 2 FACILITY PRO530018 RAYMOND VON FLUE Inactive [ ] [ ] <br /> 1895-CaIARP FAC STATE SURCHARGE FEE PR0522226 HAZ MAT SJC DES Inactive <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512575 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 2226-CaIARP PROGRAM PR0514757 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510287 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 2832-AST FAC 10 K-</=100 K GAL CUMULATIVE PR0539904 ELENA MANZO Inactive [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0530758 HARPRIT MATTU Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533842 not assigned Inactive [ ] [ ] <br /> �DR ���t4111 <br /> of VI <br />