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ldh� 190, <br /> SAN JOAQUWOUNTY ENVIRONMENTAL HEALTH EPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/23/2014 <br /> Submitted on: 2/16/2014 1:31:52PM CERS ID: 10181543 <br /> Submitted by: marc marceron Email: marc.marceron@usw.salvationarmy.org Facility ID in CERS: FA0003949 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000324 <br /> Owner name SALVATION ARMY, THE The Salvation Army 111 <br /> Mailing address 1247 S WILSON WAY 180 E. Ocean Blvd 3rd Floor 113 <br /> STOCKTON, CA 95205 Long Beach, CA 90802 114, 115, 116 <br /> Work phone 310-541-4720 ( (562)491-4100 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003949 <br /> Facility name SALVATION ARMY ADULT REHAB SALVATION ARMYADULT REHAB 3 <br /> Site address 1247 S WILSON WAY 1247 S WILSON WAY 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95205 95205 105 <br /> Facility phone 209-466-3871 (209)466-3871 0 102 <br /> Facility mailing address 1247 S WILSON WAY 1247 S WILSON WAY 108a <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name SALVATION ARMY, THE Desiree Razon 140 <br /> Address 30840 HAWTHORNE BLVD 1247 S Wilson Way 143 <br /> RANCHO PALOS VERDE, CA 90274 Stockton, CA 95205 144, 145, 146 <br /> Contact phone 209-466-3871 (209)466-3871 141 <br /> Contact email desiree.razon@usw.salvationarmy.org 142 <br /> Mail invoices to -CU=er--10 <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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: Date: 13 �1 -A <br /> ------------ — <br /> Accounting: Reviewed by: Dat : Clerical—:— <br /> File [ ] Relabel file [ ] Create new file <br /> --filledSurch ge ven8e*d By: Date_ <br /> ------ -- ------------ - <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 PR0519680 HAZA SAEED Active [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0231298 LETITIA BRIGGS Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509492 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0538027 ALFONSO ARAMBULA Active [ ] [ ] <br />