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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1111512017 <br /> Submitted on: 11/7/2017 11:00:30AM CERS ID: 10744768 <br /> Submitted by: William STOERMER Email: bstoermer53@gmail.com Facility ID in CERS: incorrect <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 I D OW0015095 <br /> Owner name STOERMER, BILL Fremont Plaza Ace Hardware LLC 111 <br /> Mailing address 2060 E FREMONT ST 2060 E. Fremont Street 113 <br /> STOCKTON, CA 95205 Stockton, CA 95205 114, 115, 116 <br /> Work phone 209-451-1459 2094511459 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0018376 <br /> Facility name FREMONT PLAZAACE HARDWARE Fremont Plaza Ace Hardware 3 <br /> Site address 2060 E FREMONT ST 2060 E Fremont St 103 <br /> City STOCKTON Stockton 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 209-451-1459 209-451-1459 102 <br /> Facility mailing address 2060 E FREMONT ST 2060 E. Fremont Street 108a <br /> STOCKTON, CA 95205 Stockton, CA 95205 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name FREMONT PLAZAACE HARDWARE Bill Stoermer 140 <br /> Address 2060 E FREMONT ST 2060 E. Fremont Street 143 <br /> STOCKTON, CA 95205 Stockton, CA 95205 144, 145, 146 <br /> Contact phone 209-451-1459 2094511459 141 <br /> Contact email BHibler@FremontPlazaAce.com bstoermer@Sandalwoodmc.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP SQG HW [ ] LQG HW [ ] RCRA HW New PR#: RZ0510370 <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: 1_170 <br /> Assigned to: VACW*3 <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> `�✓ <br /> Processed through CERS Integration Wizard' by: , L;)— Date. I kg ]7 <br /> Accounting: Reviewed by: Date: I IS I'j Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ,Acct billed [ ] Surcharge verified __ ___ By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 2 chem units PRO527117 ROBERT LOPEZ Active [ ] [ ] <br /> c5 �� pQrrr CCRS <br /> 0 3 -7 <br /> 5-D <br />