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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/6/2015 <br /> Submitted on: 1/5/2015 5:04:26PM CERS ID: 10119757 <br /> Submitted by: Navid Rezaei Email: navid.rezaei@epicplastics.com Facility ID in CERS: FA0015161 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0012141 <br /> Owner name PACIFIC COAST COMPANIES Basalite Concrete Products LLC 111 <br /> Mailing address 104 E TURNER RD 605 Industrial Way 113 <br /> LODI, CA 95240 Dixon, CA 95620 114, 115, 11E <br /> Work phone 916-631-6500 707-678-1901 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015161 <br /> Facility name EPIC PLASTICS INC EPIC PLASTICS, INC. 3 <br /> Site address 104 E TURNER RD 104 E Turner Rd 103 <br /> City LODI 104 <br /> ZIP code 95240 95240 105 <br /> Facility phone 209-333-6161 2093336161 102 <br /> Facility mailing address 104 E TURNER RD Lodi 104 East Turner Road 108a <br /> LODI, CA 95240 Lodi, CA 95240 108b,108c,10e <br /> BILLING INFORMATION <br /> Contact name EPIC PLASTICS INC Maureen Cleary 140 <br /> Address 104 E TURNER RD 104 East Turner Road 143 <br /> LODI, CA 95240 Lodi, CA 95240 144, 145, 14t <br /> Contact phone Not Specified 209-365-2123 141 <br /> Contact email mcleary@epicplastics.com 142 <br /> Mail invoices to Owner/% <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: U-t Date: tlfl�s <br /> Accounting: Reviewed by: Date: 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 PR0522250 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2221 -USED OIL ONLY-<5 TONS/YR PRO538427 ARIS VELOSO Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO526283 AMANDA BOERTIEN Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532625 not assigned Inactive [ ] [ ] <br />