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i <br /> SAN JOAQU WOUNTY ENVIRONMENTAL HEALT EPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/14/2015 <br /> Submitted on: 12/14/2015 11:50:53AM ERS ID: 10184513 <br /> Submitted by: abel montijo Email: abelmontijo@yahoo.com Facility I in CERS: FA0013670 <br /> Information prior to CIW processing Information after CIW pr cessing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 2 <br /> Owner ID OW0010779 <br /> Owner name MONTIJO, RUDY MONTIJO, RUDY 111 <br /> Mailing address 340 N WILSON WAY 340 N WILSON WAY i 113 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 114, 115, 116 <br /> Work phone 209-473-2266 2094624460 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0013670 <br /> Facility name EL CAMINO TIRES (WILSON) EL CAMINO TIRES (WILSON) 3 <br /> Site address 340 N WILSON WAY 340 N WILSON WAY 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-462-4460 (209)462-4460 102 <br /> Facility mailing address 340 N WILSON WAY 340 N WILSON WAY 108a <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 108b,108c,108d <br /> i <br /> BILLING INFORMATION <br /> Contact name EL CAMINO TIRES (WILSON) EL CAMINO TIRES (WILSON) 140 <br /> Address 340 N WILSON WAY 340 N WILSON WAY j 143 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 144, 145, 146 <br /> Contact phone Not Specified 2094624460 141 <br /> Contact email elcaminotire@yahoo.com j 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: Vlf\) Date: �a-'t"-i- k <br /> Accounting: Reviewed by: Date: 12-11-5711-'15' Clerical: File Relabel#Ie <br /> [ ] [ ] [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ---- -- ------------ <br /> ACTIVE <br /> -- —ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 2220-SM HW GEN<5 TONSNR PR0518059 CINDY VO Active [ ] <br /> 4740 WASTE TIRE SITE-EXEMPTPR0522796 BENJAMIN ESCOTTO Active 1 [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PR0521029 HAZA SAEED Inactive [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0518060 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531883 not assigned Inactive [ ] [ ] <br /> tje(�,D 71;3 C IV P-)AA ��- l r.»/�--,.iy'D�j <br /> i <br /> I <br /> 1 <br /> I <br /> i <br /> i <br /> i <br /> I <br />