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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 6/10/2016 <br />Submitted on: 4/28/2016 6:08:52AM <br />CERS ID: 10668004 <br />Submitted by: Armando Padilla Email: armando@ghaimanagement.com <br />Facility <br />ID in CERS: incorrect <br />Information prior to CIW processing <br />Information after CIW processing CERS <br />OWNER INFORMATION (current EC database) <br />(current submittal) field <br />Number of Facilities for this Owner : 8 <br />Owner ID OW0005503 <br />Owner name GHAT, SUNNY <br />Sunny Ghai <br />111 <br />Mailing address 1904 VIA DI SALERNO <br />25 E. Airway Blvd. <br />113 <br />PLEASANTON, CA 94566-2117 <br />Livermore, CA 94551 <br />114, 115,116 <br />Work phone Not Specified <br />(510)333-7802 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID FA0023425 <br />Facility name BURGER KING #22460 <br />Burger King 22460 <br />3 <br />Site address 15119 S HARLAN RD <br />15119 S Harlan Rd <br />103 <br />City LATHROP <br />Lathrop <br />104 <br />ZIP code 95330 <br />95330 <br />105 <br />Facility phone Not Specified <br />510 508-8934 <br />102 <br />Facility mailing address 15119 S HARLAN RD <br />15119 S Harlan Rd <br />108a <br />LATHROP, CA 95330 <br />Lathrop, CA 95330 <br />108b, 108c, 1084 <br />BILLING INFORMATION <br />Contact name BURGER KING #22460 <br />Sunny Ghai <br />140 <br />Address 15119 S HARLAN RD <br />25 E. Airway Blvd. <br />143 <br />LATHROP, CA 95330 <br />Livermore, CA 94551 <br />144, 145, 146 <br />Contact phone 510-333-7802 <br />(510) 333-7802 <br />141 <br />Contact email <br />sunny@ghaimanagement.com 142 <br />Mail invoices to Facility <br />Program record [ HMBP [ ] SQG HW [ ] LQG HW <br />[ ] RCRA HW New PR#: <br />Ff' 094 <br />created [ ] Tiered permit [ ] APSA [ ] CalARP <br />[ ] UST —rNew PE: <br />M (0I <br />Assigned to: <br />PAY- <br />Please bill: [ ] full calendar year [ ] prorate t ' calendar year [ ] next calendar year [ <br />] exempt from billing <br />Processed through CERS Integration Wizard by: (� <br />Date: ©(0j1Lg j (p <br />-------------------------------------------------- <br />Accounting: Reviewed by: te-L) Date: 410 / <br />Clerical: [ ] File [ ] Relabel <br />file [ ] Create new file <br />[ ,Acct billed--[ FSurcharge verified <br />------------------------------------- <br />By: <br />Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO <br />PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name Status <br />Reactivated Inactivated <br />1625 - RESTAURANT/BAR 51-100 SEATS PR0540938 MELISSA NISSIM Active <br />[ I [ I <br />P'o I C�ievi <br />lyw 2go 74v <br />