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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/15/2017 <br /> Submitted on: 6/10/2017 12:25:01 PM CERS ID: 10737628 <br /> Submitted by: Michael Morowit Email! morowitmike@yahoo.com Facility ID in CERS: incorrect <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 OW0000418 111 <br /> Owner name MOROWIT, MIKE Mike Morowit <br /> Mailing address 1046 W YOSEMITE AVE 1046 W Yosemite Ave 113 <br /> MANTECA, CA 953375341 Manteca, CA 95337 11a, 115, Its <br /> Work phone 209-823-6930 209-612-2143 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000506 3 <br /> Facility name MINER MART#2 Miner Mart <br /> 1046 W Yosemite Ave 103 <br /> Site address 1046 W YOSEMITE AVE <br /> City MANTECA Manteca 104 <br /> ZIP code 95337 95337 105 <br /> Facility phone 209-823-6930 209-612-2143 102 <br /> Facility mailing address 1046 W YOSEMITE 1046 W Yosemite Ave 108a <br /> MANTECA, CA 95337 Manteca, CA 95337 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name MINER MART#2 Mike Morowit 140 <br /> Address 1046 W YOSEMITE 1046 W Yosemite Ave 143 <br /> MANTECA, CA 95337 Manteca, CA 95337 1aa, 14 1a6 <br /> Contact phone 209-823-6930 209-823-6930 1411 <br /> Contact email 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] 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: , t-P ` Date: <br /> Accounting: Reviewed by: Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRI PROCESSI OUGH CIW <br /> Record Employee name Stat ; Reactivated Inactivated <br /> 1615-RETAIL MKT 301-2000 50 FT(PREPKGDILTD PREP, PR0161 07 KADEANNE LINHARES Active I I I I <br /> [ 4 <br /> ��l.l� S ►r� �/K.+O r <br /> C'm P <br /> osd 4, be, t-,,osa-bML" <br /> L�� <br />