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t <br /> SAN JOAQUOROUNTY ENVIRONMENTAL HEALTF REPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/20/2014 <br /> Submitted on: 3/7/2014 12:47:26PM CERS ID: 10180793 <br /> Submitted by: BETH GRUBA Email: bethg@harmans.com Facility ID in CERS: FA0001652 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000440 <br /> Owner name OVERZET 225 INC HARMAN-LEX INC 111 <br /> Mailing address PO BOX 572530 8334 GERBER RD 113 <br /> SALT LAKE CITY, UT 84517-2530 SACRAMENTO, CA 95828-3710 114, 115, 116 <br /> Work phone 801-313-8000 916-689-2190 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0001652 <br /> Facility name KFC HARMAN-LEX#225 KFC HARMAN-LEX #225 3 <br /> Site address 1537 N WILSON WAY 1537 N WILSON WAY 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 952053119 95205-3119 105 <br /> Facility phone 209-462-5929 (209)462-5929 102 <br /> Facility mailing address PO BOX 572530 8334 GERBER RD 108a <br /> SALT LAKE CITY, UT 84517-2530 SACRAMENTO, CA 95828-3710 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name KFC#225 KFC HARMAN-LEX #225 140 <br /> Address PO BOX 572530 P.O. BOX 572530 143 <br /> SALT LAKE CITY, UT 84517-2530 SALT LAKE CITY, UT 84157 144, 145, 146 <br /> Contact phone Not Specified 916-689-2190 141 <br /> Contact email 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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: <br /> ---------------------- --------------------------- <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 /> 1625-RESTAURANT/BAR 51-100 SEATS PRO160512 STEPHANIE RAMIREZ Active I 1 I 1 <br /> 1921 -HMBP-Regular-Primary Location PR0529908 LOWELL ALLEN Active [ ] [ 1 <br /> 2066-MILK DISPENSER PR0200235 WILLIAM MARCHESE Inactive [ ] I ] <br />