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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 8/16/2017 <br /> Submitted on: 7/17/2017 11:35:55AM CERS ID: 10646164 <br /> Submitted by: MASHIN MOHAMMAD Email: mashin83@hotmail.com Facility ID in CERS: FA0022837 <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: 1 <br /> Owner ID OW0020755 <br /> Owner name CENTRAL VALLEY AUTO TECH MASHIN MOHAMMAD 111 <br /> Mailing address 121 S WILSON WAY 10313 ALMANOR CIR 113 <br /> STOCKTON, CA 95205 STOCKTON, CA 95219 114, 115, 116 <br /> Work phone ULA Ibrahim —Uorie4' 2094627000 112 <br /> FACILITY FILE INFORMATION fv Ack-DO 450 3 <br /> Facility ID FA0022837 <br /> Facility name CENTRAL VALLEYAUTO TECH CENTRAL VALLEY AUTO TECH 3 <br /> Site address 121 S WILSON WAY 121 S Wilson Way 103 <br /> City STOCKTON Stockton 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-462-7000 2094627000 102 <br /> Facility mailing address 121 S WILSON WAY 121 S WILSON WAY 108a <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 108b, 108c,1084 <br /> BILLING INFORMATION <br /> Contact name CENTRAL VALLEY AUTO TECH MASHIN MOHAMMAD 140 <br /> Address 121 S WILSON WAY 10313 almanor cir 143 <br /> STOCKTON, CA 95205 STOCKTON, CA 95219 144. 145, 146 <br /> Contact phone Not Specified 2092635443 141 <br /> Contact email mashin83@hotmaiI.com 142 <br /> Mail invoices to Account <br /> Program record HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: PRO 9%95 <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: 11l-I <br /> Assigned to: Lope-2_ <br /> Please bill: [ ] full calendar year [ ] proratethiscalendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: 'J�n0v'^ Date: �✓ - ]c�[7 <br /> Accounting: Reviewed by: _ 146 Date: g.4a 7 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> Acct billed [ ] SLFGhergeven ied— By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 2220-SM HW GEN<5 TONSNR PRO539930 THREE VACANT3 Active [ ] [ ] <br />