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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 6/28/2016 <br />Submitted on: 6/27/2016 3:15:19PM <br />Submitted by: Maggie Ta Email: maggie.ta@cbi.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 />OW0015613 <br />Lowe's Home Centers, LLC <br />1605 Curtis Bridge Rd, Mailcode A2ELP <br />Wilkesboro, NC 28697 <br />704-758-6033 <br />FACILITY FILE INFORMATION <br />CERS ID: 10187019 <br />Facility ID in CERS: FA0018976 <br />Information after CIW processing CERS <br />(current submittal) field <br />Lowe's Home Centers, LLC 111 <br />1605 Curtis Bridge Rd, Mailcode A2ELP 113 <br />Wilkesboro, NC 28697 114, 115, 116 <br />(704) 758-6033 112 <br />Facility ID <br />FA0018976 <br />Employee name <br />Status Reactivated Inactivated <br />Facility name <br />LOWE'S #1430 <br />LOWE'S #1430 <br />3 <br />Site address <br />512 LUCE AVE <br />512 LUCE AVE <br />103 <br />City <br />STOCKTON <br />STOCKTON <br />104 <br />ZIP code <br />95203 <br />95203 <br />105 <br />Facility phone <br />888-429-6281 <br />(888) 429-6281 <br />102 <br />Facility mailing address <br />1000 Lowe's Blvd, Mail Code A2ELP <br />1000 Lowe's Blvd., Mail Code A2ELP <br />108a <br />Mooresville, NC 28117 <br />Mooresville, NC 28117 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name LOWE'S #1430 <br />Address 1000 Lowe's Blvd, Mail Code A2ELP <br />Mooresville, NC 28117 <br />Contact phone Not Specified <br />Contact email Robert.A.Gass@lowes.com <br />Mail invoices to Account <br />Rob Gass 140 <br />1000 Lowe's Blvd., Mail Code A2ELP 143 <br />Mooresville, NC 28117 144, 145, 146 <br />(704) 758-6033 141 <br />Robert.A.Gass@lowes.com 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 th* alendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: Date: <br />Accounting: Reviewed by: tft Date: �r v? 1 f 4 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 <br />Record ID <br />Employee name <br />Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location <br />PR0528006 <br />ROBERT LOPEZ <br />Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR <br />PRO539208 <br />STACY RIVERA <br />Active [ ] [ ] <br />2831 - AST FAC >/= 1,320 - <10 K GAL CUMULATIVE <br />PR0540728 <br />STACY RIVERA <br />Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI <br />PR0531703 <br />not assigned <br />Inactive [ ] [ ] <br />