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SAN JOAQUI, ..OUNTY ENVIRONMENTAL HEALTI-..jEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard tic <br />Date run: 7/9/2014 <br />Submitted on: 2/28/2014 5:05:52PM <br />Submitted by: Elizabeth Campos Email: ecampos@3ecompany.com <br />CERS ID: 10415479 <br />Facility ID in CERS: FA0013341 <br />Information prior to CIW processing Information after CIW processing <br />OWNER INFORMATION (current EC database) (current submittal) <br />Owner ID OW0001014 <br />Owner name Walgreen Co Walgreen Co. <br />Mailing address 200 Wilmot Road 200 Wilmot Rd. <br />6I- Deerfield, IL 60015 <br />Work phone 847-914-2264 (847) 914-2264 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0013341 <br />Facility name <br />Walgreens #15398 <br />Site address <br />660 W March Ln <br />City <br />Stockton <br />Zip code <br />95207 <br />Facility phone <br />209-478-0891 <br />Facility mailing addres <br />3207 Grey Hawk Ct Suite 200 <br />Carlsbad, CA 92010 <br />BILLING INFORMATION <br />Contact name Walgreens #15398 <br />Address 3207 Grey Hawk Ct Suite 200 <br />Carlsbad, CA 92010 <br />Contact phone Not Specified <br />Contact email regulatory@3ecompany.com <br />Mail invoices to Facility <br />Walgreens #15398 <br />660 W March Ln <br />Stockton <br />95207 <br />(209) 478-0891 <br />Carlsbad, CA 92010 <br />CERS <br />field <br />111 <br />113 <br />114, 115, 116 <br />112 <br />3 <br />103 <br />104 <br />105 <br />102 <br />108a <br />108b, 108c, 108d <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />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 />----------- ff ---- ----------------------------- <br />Accounting: Reviewed by: Date: —Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />j"�0115&D? [k Acct billed _ ;}-S; By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name Status Reactivated Inactivated <br />1618 - RETAIL MKT >2000 SO FT (PREPKGD / LTD PREP) PR0517326 MARIBEL FLOHRSCHUTZ Active [ ] [ ] <br />1921 - HMBP-Regular-Primary Location PR0538633 HAZ MAT SJC OES Inactive P•] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0538453 MICHELLE HENRY Active [ ] [ ] <br />4557 - MED WASTE LIMITED HAULER PR0537693 ROBERT MCCLELLON Active [ ] [ ] <br />140 <br />3207 Grey Hawk Ct., Suite 200 <br />143 <br />Carlsbad, CA 92010 <br />144, 145, 146 <br />(760) 602-8700 <br />141 <br />regulatory@3ecompany.com <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />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 />----------- ff ---- ----------------------------- <br />Accounting: Reviewed by: Date: —Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />j"�0115&D? [k Acct billed _ ;}-S; By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name Status Reactivated Inactivated <br />1618 - RETAIL MKT >2000 SO FT (PREPKGD / LTD PREP) PR0517326 MARIBEL FLOHRSCHUTZ Active [ ] [ ] <br />1921 - HMBP-Regular-Primary Location PR0538633 HAZ MAT SJC OES Inactive P•] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0538453 MICHELLE HENRY Active [ ] [ ] <br />4557 - MED WASTE LIMITED HAULER PR0537693 ROBERT MCCLELLON Active [ ] [ ] <br />