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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 1/22/2016 <br />Submitted on: 1/14/2016 6:28:01PM <br />Submitted by: Sean Birch Email: sean.birch@calwestcci.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 />OW0002703 <br />BIRCH, WELDON <br />1153 VANDERBILT CIR <br />MANTECA, CA 95337 <br />510-656-0253 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0003617 <br />Facility name <br />CAL WEST CONCRETE CUTTINGS INC <br />Site address <br />1153 VANDERBILT CIR <br />City <br />MANTECA <br />ZIP code <br />95337 <br />Facility phone <br />209-823-2236 <br />Facility mailing address <br />PO BOX 4460 <br />Accounting: Reviewed by: � Date: Clerical: <br />MANTECA, CA 95337-0008 <br />BILLING INFORMATION <br />By: Date: <br />Contact name <br />CAL WEST CONCRETE CUTTINGS INC <br />Address <br />PO BOX 4460 <br />Active [ ] [ ] <br />MANTECA, CA 95337-0008 <br />Contact phone <br />Not Specified <br />Contact email <br />Inactive [ ] [ ] <br />Mail invoices to <br />Account <br />CERS ID: 10181245 <br />Facility ID in CERS: FA0003617 <br />Information after CIW processing CERS <br />(current submittal) field <br />BIRCH, WELDON 111 <br />1153 VANDERBILT CIR 113 <br />MANTECA, CA 95337 114, 115, 116 <br />(510)656-0253 112 <br />CAL WEST CONCRETE CUTTINGS INC 3 <br />1153 VANDERBILT CIR 103 <br />MANTECA 104 <br />95337 105 <br />(209) 823-2236 102 <br />1153 VANDERBILT CIR 108a <br />MANTECA, CA 95337 108b, 108c, 108d <br />CAL WEST CONCRETE CUTTINGS INC 140 <br />1153 VANDERBILT CIR 143 <br />MANTECA, CA 95337 144, 145, 146 <br />(209)823-2236 141 <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LOG 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 [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: Q/T'i Date: <br />Accounting: Reviewed by: � Date: 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 />Pro ram Element and Description Record ID Employee name <br />Status Reactivated Inactivated <br />921 - HMBP-Regular-Primary Location PR0520349 PETER LOMBARDI <br />Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0513841 ELENA MANZO <br />Active [ ] [ ] <br />2381 - UST FACILITY (BEFORE 1/84) - obsolete PR0231745 ALISON YOUNGBLOOD Inactive [ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509446 HAZ MAT SJC OES <br />Inactive [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0533846 not assigned <br />Inactive <br />