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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 5/12/2017 <br /> Submitted on: 5/10/2017 1:25:49PM CERS ID: 10184857 <br /> Submitted by: Ramon Mata Email: ramon@pacificboatservices.com Facility ID in CERS: FA0015065 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner : 2 <br /> Owner ID OW0016825 n <br /> Owner name MATA, RAMON MATA, RAMON ggg0 Rid $14A0 *A 111 <br /> Mailing address 4235 ROUND VALLEY CIR ramon@pacificboatservices.com 113 <br /> STOCKTON, CA 95207 t.pgE�44 114. 115, 116 <br /> Work phone 209-334-2127 2093342127 �5Z 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015065 <br /> Facility name PACIFIC BOAT SERVICES PACIFIC BOAT SERVICES 3 <br /> Site address 8090 N RIO BLANCO RD 8090 N RIO BLANCO RD 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95219 95219 105 <br /> Facility phone 209-334-2127 (209) 334-2127 102 <br /> Facility mailing address 8090 Rio Blanco Rd#A 8090 Rio Blanco Rd#A 108a <br /> Stockton, CA 95219 Stockton, CA 95219 108b, 1080,108d <br /> BILLING INFORMATION <br /> Contact name PACIFIC BOAT SERVICES PACIFIC BOAT SERVICES 140 <br /> Address 8090 N RIO BLANCO RD#A 8090 N RIO BLANCO RD#A 143 <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 144, 145, 146 <br /> Contact phone 209-334-2127 209-334-2127 141 <br /> Contact email ramon@pacificboatservices.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 <br /> //�� y [ ] exempt from billing <br /> Processed through CERS Integration <br /> Wizard by: '.Ow Date: <br /> Accounting: Reviewed by: Date: 51 iii / Clerical: [ ] File [ ] Relabel file [ ] Create new rile <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 4 chem units PRO541265 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0522105 AARON HANG Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0532195 not assigned y Inactive <br /> I. <br /> L(-k N� la�lZ. �'a t7"r,y{ker� +0 CGlr/let.-k On..we,r Mti��trJ1� ^�feSS. I✓or�n'�— <br />