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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 7/25/2017 <br />Submitted on: 7/24/2017 12:46:07AM CERS ID: 10734877 <br />Submitted by: Ranjan Bhasin Email: rb@fpfginc.com Facility ID in CERS: incorrect <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 />OW0017387 <br />XFINITY HOLDING LLC <br />1063 CHESHIRE CIR <br />DANVILLE, CA 94506 <br />209-477-8207 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0002784 <br />Facility name <br />WINGSTOP <br />Site address <br />5052 WEST LN STE 4L <br />City <br />STOCKTON <br />ZIP code <br />95210 <br />Facility phone <br />209-477-8207 <br />Facility mailing address <br />1063 CHESHIRE CIR <br />5052 West Ln # 4L <br />DANVILLE, CA 94506 <br />BILLING INFORMATION <br />104 <br />Contact name <br />WINGSTOP <br />Address <br />1063 CHESHIRE CIR <br />DANVILLE, CA 94506 <br />Contact phone <br />925-736-8646 <br />Contact email <br />Mail invoices to <br />Facility <br />Information after CIW processing CERS <br />(current submittal) field <br />Ranjan Bhasin 111 <br />1063 Cheshire Circle 113 <br />Danville, CA 94506 114, 115, 116 <br />9252603605 112 <br />Wingstop <br />3 <br />5052 West Ln # 4L <br />103 <br />Stockton <br />104 <br />95210 <br />105 <br />2094778207 <br />102 <br />1063 Cheshire Circle 108a <br />Danville, CA 94506 108b, 108c, 108d <br />ranjan Bhasin <br />140 <br />1063 Cheshire Circle <br />143 <br />Danville, CA 94506 <br />144, 145, 146 <br />925263605 <br />141 <br />rb@fpfginc.com <br />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 [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: OA Date: <br />Accounting: Reviewed by: � Date: ?(Z�i� i Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ LAcct hillarl r Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactivated Inactivated <br />1624 - RESTAURANT/BAR 21-50 SEATS PRO163107 JEFFREY WONG Active [ ] [ ] <br />1919 - HMBP-0O2 Only Food Facility 1 chem units PR0541870 JEFFREY WONG Active [ ] [ ] <br />L � A'„ oe 04 (9ti AV 0 �Pfmy 5!3 Sed CCkr'PtAe5cj , <br />