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SAN JOAQUIN _JUNTY ENVIRONMENTAL HEALTH u.PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 10/5/2015 <br /> Submitted on: 9/29/2015 2:28:27PM CERS ID: 10183655 <br /> Submitted by: Mike Mason Email: mmason@holtca.com Facility ID in CERS: FA0010595 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner I D OW0008595 <br /> Owner name HOLT OF CA HOLT OF CALIFORNIA 111 <br /> Mailing address PO BOX X PO BOX 100001 113 <br /> SACRAMENTO, CA 95813-1306 Sacramento, CA 95813-1306 114, 115, 116 <br /> Work phone 916-991-8200 916-991-8200 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010595 <br /> Facility name HOLT OF CA HOLT OF CA 3 <br /> Site address 1234 W CHARTER WAY 1234 W CHARTER WAY 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209-462-3660 (209) 946-6510 102 <br /> Facility mailing address PO BOX X P.O. Box "X" 108a <br /> SACRAMENTO, CA 95813-1306 Sacramento, CA 95813-1306 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name HOLT OF CA Mike Mason 140 <br /> Address PO BOX X PO BOX 100001 143 <br /> SACRAMENTO, CA 95813-1306 SACRAMENTO, CA 95813-1306 144, 145, 146 <br /> Contact phone 916-991-8200 916-921-8917 141 <br /> Contact email mmason@holtca.com 142 <br /> Mail invoices to Fallity (� <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 <br /> o:Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: \AA Date: [0` �r <br /> --------------------------------------------------_ <br /> Accounting: Reviewed by: Date: )D j�j l s Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> -------------------------------------------------- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PR0512883 ROBERT LOPEZ Active [ ] [ ] <br /> 2227-GEN 5<25 TONS PERMIT PR0519075 THUY TRAN Active [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PRO528303 THUY TRAN Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523138 ALFONSO ARAMBULA Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510595 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO534208 not assigned Inactive [ ] [ ] <br />