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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 11/24/2014 <br /> Submitted on: 11120/2014 7:53:16AM CERS ID: 10184593 <br /> Submitted by: PETE PARAFIN Email: FLUIDMFG@AOL.COM Facility ID in CERS: FA0014299 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0011353 <br /> Owner name CARY& LYNNETTE PARAFIN CARY& LYNNETTE PARAFIN 111 <br /> Mailing address 804 BLACK DIAMOND WAY 804 BLACK DIAMOND WAY 113 <br /> LODI, CA 95240 LODI, CA 95240 114, 115, 11E <br /> Work phone 209-334-6144 209-786-4484 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0014299 <br /> Facility name FLUID MANUFACTURING FLUID MANUFACTURING 3 <br /> Site address 804 BLACK DIAMOND WAY 804 BLACK DIAMOND WAY 103 <br /> City LODI LODI 104 <br /> ZIP code 95240 95240 105 <br /> Facility phone 209-334-6144 (209) 334-6144 0 102 <br /> Facility mailing address 804 BLACK DIAMOND WAY 804 BLACK DIAMOND WAY 108a <br /> LODI, CA 95240 LODI, CA 95240 108b,lose.10E <br /> BILLING INFORMATION <br /> Contact name FLUID MANUFACTURING FLUID MANUFACTURING 140 <br /> Address 804 BLACK DIAMOND WAY 804 BLACK DIAMOND WAY 143 <br /> LODI, CA 95240 LODI, CA 95240 144, 145, 14( <br /> Contact phone Not Specified 209-334-6144 141 <br /> Contact email 142 <br /> Mail invoices to G wnwl, <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: Date: <br /> Accounting: Reviewed by: Date: 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 -HMBP-Regular-Primary Location PR0521263 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0519174 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533059 not assigned Inactive [ ] [ ] <br />