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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/27/2014 Submitted on: 5/21/2014 3:30:01PM CERS ID: 10184399 Submitted by: henry rotor Email: henry@alegretrucking.com Facility ID in CERS: FA0013538 Information prior to CIW processing Information after CIW processing CERS OWNER INFORMATION (current EC database) (curve submittal) field Owner ID OW0010664 Owner name FTG CONSTRUCTION MATERIALS Frank C. Alegre SR. 111 Mailing address PO BOX 1508 PO BOX 1508 113 LODI, CA 952411508 LODI, CA 95241-1508 114, 115, 116 Work phone 209-339-0665 209-334-2112 112 FACILITY FILE INFORMATION Facility ID FA0013538 Facility name FTG CONSTRUCTION MATERIALS FTG CONSTRUCTION MATERIALS 3 Site address 5112 W HWY 12 5112 W HWY 12 103 City LOD] LODI 104 Zip code 95242 95242 105 Facility phone 209-334-4038 (209) 334-4038 0 102 Facility mailing address PO BOX 1508 PO BOX 1508 108a LODI, CA 952411508 LOD], CA 95241-1508 108b,108c,1oad BILLING INFORMATION Contact name FTG CONSTRUCTION MATERIALS FTG CONSTRUCTION MATERIALS 140 Address PO BOX 1508 PO BOX 1508 143 LODI, CA 952411508 LODI, CA 95241-1508 144, 145, 146 Contact phone Not Specified 209-334-2112 141 Contact email 142 Mai] invoices to Facility Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: created [ ] Tiered permit [ ] APSA [ j CalARP [ ] UST New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [ ]/,,next calendar year [ ] exempt from billing Processed through CERS Integration Wizard by: RQ 1_ Date: 0 � 1 -------------- ------ -- --y--- -- -- Accounting: Reviewed by: Date:� Clerical: File [ ] Relabel file [ ] Create new file [ ] A Illed [ ] Sur ge verified B : Date: _ — -- --- ---------- ------------- - ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Program Element and Description Record ID Employee name Status Reactivated Inactivated 1921 -HMBP-Regular-Primary Location PR0521101 JAMIE DE LA ROSA Active [ ] [ ] 2220-SM HW GEN<5 TONSNR PR0528438 ARIS VELOSO Active [ ] [ ] 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO617652 HAZ MAT SJC OES Inactive [ ] [ ] 2840-AST EXEMPT FAC <1,320 GAL PRO528411 ARIS VELOSO Active,Exempt [ ] [ ] 4740-WASTE TIRE SITE-EXEMPT PRO523821 Garrett Alias-Backus Inactive [ ] [ ] ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0532951 not assigned Inactive [ ] [ ]