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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 1/25/2016 <br />Submitted on: 1/15/2016 6:21:28AM <br />Submitted by: Sheila Caballero Email: sheila.caballero@shawgrp.com <br />Information prior to CIW processing <br />OWNER INFORMATION (current EC database) <br />Number of Facilities for this Owner : 1 <br />Owner ID OW0015613 <br />Owner name Lowe's Home Center, LLC <br />Mailing address 101 Andover Park East, Ste 200 c/o Mailcod <br />Tukwila, WA 98188 <br />Work phone 206-242-8570 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0018976 <br />Facility name <br />LOWE'S #1430 <br />Site address <br />512 LUCE AVE <br />City <br />STOCKTON <br />ZIP code <br />95203 <br />Facility phone <br />888-429-6281 <br />Facility mailing address 1000 LOWE'S BLVD <br />MOORESVILLE, NC 29117 <br />BILLING INFORMATION <br />Contact name <br />LOWE'S #1430 <br />Address <br />1000 Lowe's Blvd <br />t921 - HMBP-Regular-Primary Location <br />MOORESVILLE, NC 28117 <br />Contact phone <br />704-758-6033 <br />Contact email <br />Robert.A.Gass@lowes.com <br />Mail invoices to <br />Account <br />CERS ID: 10187019 <br />Facility ID in CERS: FA0018976 <br />Information after CIW processing CERS <br />(current submittal) field <br />Lowe's Home Center, LLC 111 <br />101 Andover Park East, Ste 200 c/o Mailcod 113 <br />Tukwila, WA 98188 114, 115, 116 <br />206-242-8570 112 <br />LOWE'S #1430 3 <br />512 LUCE AVE 103 <br />STOCKTON 104 <br />95203 105 <br />888-429-6281 102 <br />1000 LOWE'S BLVD 108a <br />MOORESVILLE, NC 29117 108b, 108c,108d <br />Rob Gass 140 <br />1000 Lowe's Blvd 143 <br />MOORESVILLE, NC 28117 144, 145, 146 <br />704-758-6033 141 <br />Robert.A.Gass@lowes.com 142 <br />Program record [ ] HMQP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br />created [ ] Tiered permit APSA [ ] CaIARP [ ] 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: , -,� '-) - ( ' <br />Accounting: Reviewed by: Date: I aZL Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct biNed Surcharge verified By: Date: <br />-------------------------------------------------- <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 />t921 - 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 />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI <br />PR0531703 <br />not assigned <br />Inactive [ ] [ ] <br />