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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 8/14/2018 <br />Submitted on: 4/4/2018 9:28:41AM CERS ID: 10184331 <br />Submitted by: MAREK WIATR Email: marekwi@dispatch2.com Facility ID in CERS: FA0012730 <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 />OW0009916 <br />GAWRYSIUK, MARGARET <br />10727 MULBERRY AVE <br />FONTANA, CA 92337 <br />559-233-8444 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0012730 <br />Facility name <br />FLAME TRANS <br />Site address <br />781 SWIFT WAY <br />City <br />STOCKTON <br />ZIP code <br />95206 <br />Facility phone <br />209-851-5388 <br />Facility mailing address <br />6800 Santa Fe Dr. <br />Status Reactivated Inactivated <br />Hodgkins, IL 60525 <br />BILLING INFORMATION <br />2220 - SM HW GEN <5 TONS/YR PRO516666 CESAR RUVALCABA <br />Contact name <br />FLAME TRANS <br />Address <br />6800 Santa Fe Dr. <br />Inactive [ ] [ ] <br />Hodgkins, IL 60525 <br />Contact phone <br />Not Specified <br />Contact email <br />Mail invoices to <br />Account <br />Information after CIW processing CERS <br />(current submittal) field <br />Margaret Gawrysiuk 111 <br />6800 Santa Fe DR 113 <br />Hodgkins, IL 60525 114, 115, 116 <br />909-744-5418 112 <br />ROUTE66 <br />3 <br />781 SWIFT WAY <br />103 <br />STOCKTON <br />104 <br />95206 <br />105 <br />ext 1035 <br />102 <br />6800 santa fe dr, unit b2 108a <br />Hodgkins, IL 60525 108b, 108c, 108d <br />Maria Waksmundzka 140 <br />6800 Santa Fe DR, Unit B2 143 <br />Hodgkins, IL 60525 144, 145, 146 <br />909-744-5418 ext1084 141 <br />nikiel63@gmail.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 this calendar year [ ] <br />next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard bDate: <br />Accounting: Reviewed by: — Date: <br />LV'/ g/' " Clerical: <br />[ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified <br />By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name <br />Status Reactivated Inactivated <br />1920 - HMBP-Common Materials 2 chem units PRO521082 ROBERT LOPEZ <br />Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PRO516666 CESAR RUVALCABA <br />Inactive [ ] [ ] <br />2224 - HAZ MAT BUSINESS PLAN AUTHORIZATION PR0517561 HAZ MAT SJC OES <br />Inactive [ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0516667 MICHAEL KITH <br />Inactive [ ] [ ] <br />2832 - AST FAC 10 K - </=100 K GAL CUMULATIVE PR0528344 CESAR RUVALCABA <br />Inactive [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532072 not assigned <br />Inactive [ ] [ ] <br />