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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/18/2014 <br /> Submitted on: 2/20/2014 6:41:46PM CERS ID: 10169649 <br /> Submitted by: Chris Baker Email: Chris.Baker@pscnow.com Facility ID in CERS: FA0015638 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0012261 <br /> Owner name BED, BATH & BEYOND Bed, Bath and Beyond, Inc. 113 <br /> Mailing address 650 LIBERTY AVE 650 Liberty Ave 11a, 115,116 <br /> UNION, NJ 070835201 Union, NJ 07083 112 <br /> Work phone 908-688-0888 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0015638 <br /> Facility name BED, BATH & BEYOND#811 Bed, Bath and Beyond#811 103 <br /> Site address 2886 W GRANT LINE RD 2886 W Grant Line Rd 104 <br /> City TRACY Tracy <br /> Zip code 953049453 95304 105 <br /> Facility phone 209-832-3189 209-832-3189 102 <br /> Facility mailing address 650 LIBERTY AVE 5151 San Felipe, Suite 1100 108a <br /> UNION, NJ 070835201 Houston, TX 77056 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name BED, BATH & BEYOND#811 Katherine Sloss 140 <br /> Address 650 LIBERTY AVE 650 Liberty Ave 143 <br /> UNION, NJ 070835201 Union, NJ 07083 aa, las. tab <br /> Contact phone 209-832-3189 908-855-4517 141 <br /> Contact email ✓ katherine.sloss@bedbath.com 142 <br /> Mail invoices to fine" /� <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:�,A Date: u'It't <br /> ------9-----y— — -------- --------------- <br /> Accountin Reviewed b Date: lI Clerical: ] File [ ] Relabel file [ ] Create new file <br /> [ ] Ac1lbAf2d [ ] Surcha -rifled By: Date_ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1620-RETAIL MKT 26-300 SO FT(INCIDENTAL FOODS) PRO523166 MELISSA NISSIM Active I ] I ] <br /> 2220-SM HW GEN<5 TONSNR PR0536997 THUY TRAN Active I ] I ) <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO536998 THUY TRAN Inactive [ ] [ 1 <br /> n — 7 <br />