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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 2/9/2017 <br /> Submitted on: 2/3/2017 11:34:37AM CERS ID: 10183939 <br /> Submitted by: Regina Colbert Email: rcolbert@rcainc.us Facility ID in CERS: FA0010925 <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 OW0008925 <br /> Owner name PSC INDUSTRIAL SERVICES PSC Industrial Outsourcing 111 <br /> Mailing address 2050 W FREMONT ST 2050 W FREMONT ST 113 <br /> STOCKTON, CA 95203 STOCKTON, CA 95203 114, 115,116 <br /> Work phone 800-321-1030 (800) 321-1030 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010925 <br /> Facility name PSC INDUSTRIAL SERVICES OUTFRONT MEDIA STOCKTON OFFICE 3 <br /> Site address 2050 W FREMONT ST 2050 W FREMONT ST 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95203 95203 105 <br /> Facility phone 800-321-1030 (800) 321-1030 102 <br /> Facility mailing address 2050 W FREMONT ST 2050 W. Fremont Street 108a <br /> STOCKTON, CA 95203 Stockton, CA 95203 108b,108c,mad <br /> BILLING INFORMATION <br /> Contact name PSC INDUSTRIAL SERVICES Donna Ruff 140 <br /> Address 2050 W FREMONT ST 2050 W FREMONT ST 143 <br /> STOCKTON, CA 95203 STOCKTON, CA 95203 144, 145, 146 <br /> Contact phone Not Specified (800) 321-1030 141 <br /> Contact email Donna.Ruff@pscnow.com 142 <br /> Mail invoices to Account <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: k/VN Date: -.;1-• q ' 1 1 <br /> ------ -----y-- ----- -- -- --- -- - <br /> Accounting. Reviewed b : Li16 Date: —41"7117 Clerical:Clerical: [ ] File [ ] Relabelfile [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ---------------------------- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 3 chem units PR0520553 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PRO514454 STACY RIVERA Inactive <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO513213 HAZ MAT SJC OES Inactive <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510925 HAZ MAT SJC DES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533531 not assigned Inactive [ ] [ ] <br /> [W ;�90 55 <br />