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SAN JOAQUIN-%,OUNTY ENVIRONMENTAL HEALTH,s�:PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/1512016 <br /> Submitted on: 1/11/2016 2:50:38PM CERS ID: 10182413 <br /> Submitted by Shelley Gaines Email: shelleygafnes@dentoni.com Facility ID in CERS: FAC009096 <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 OW0007096 <br /> Owner name DAVID B DENTONI DAVID B DENTONI 111 <br /> Mailing address 801 S AIRPORT WAY 801 S AIRPORT WAY 113 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 114, 115.116 <br /> Work phone 209-464-4930 209-464-4930 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009096 <br /> Facility name DENTONIS WELDING WORKS INC DENTONIS WELDING WORKS INC 3 <br /> Site address 801 S AIRPORT WAY 801 S AIRPORT WAY 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-464-4930 (209) 464-4930 0 102 <br /> Facility mailing address 801 S AIRPORT WAY 801 S AIRPORT WAY 108a <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name DENTONI`S WELDING WORKS INC DENTONI'S WELDING WORKS INC 140 <br /> Address 801 S AIRPORT WAY 801 S AIRPORT WAY 143 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 144, 145, 146 <br /> Contact phone 209-943-4836 209-943-4836 141 <br /> Contact email SHELLEYGAINES@DENTONI.COM SHELLEYGAINES@DENTONi.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: 22'.1_0 <br /> Assigned to: V D <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: A4 Date: I - , <br /> Accounting: Reviewed by: 11t) Date: _ l 1 l4l/ L,, Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMSP-Regular-Primary Location PR0519380 HAZA SAEED Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509096 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0523804 Garrett Alias-Backus Inactive [ ] ] ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532097 not assigned Inactive [ ] [ ] <br />