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SAN JOAQIhR-COUNTY ENVIRONMENTAL HEAL I' PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 7/2/2014 <br /> Submitted on: 2/26/2014 1:51:22PM CERS ID: 10187091 <br /> Submitted by: Debbie Livermore Email: debbie.livermore@stocktongov.coi Facility ID in CERS: FA0019194 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0012870 <br /> Owner name COS MUNICIPAL UTILITIES DIST CITY OF STOCKTON-MUD 111 <br /> Mailing address 2500 NAVY DR 2500 NAVY DR 113 <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 114, 115, 116 <br /> Work phone 209-937-8700 209-937-8700 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019194 <br /> Facility name WESTSIDE INTERCEPTOR SANITARY ST WESTSIDE INTERCEPTOR SANITARY ST 3 <br /> Site address 6461 BROOKSIDE RD 6461 BROOKSIDE RD 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 209-9 (209) 105 <br /> Facility phone 209-937-8750 (209) 937-8750 102 <br /> Facility mailing address 2500 NAVY DR 2500 NAVY DR 108a <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name WESTSIDE INTERCEPTOR SANITARY ST CITY OF STOCKTON-MUD 140 <br /> Address 2500 NAVY DR 2500 NAVY DR 143 <br /> Si22-TON, CA 95206 STOCKTON, CA 95206 144, 145, 146 <br /> Contact phone of Sp ified 209-937-8700 141 <br /> Contact email 142 <br /> Mail invoicest Fac' <br /> Program record [ [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: off. <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: 1012-0 <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: 1 <br /> 014, <br /> Accounting: Reviewed by: _ 14 Date: 7 2Z ! 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 /> 2831 -AST FAC >/= 1,320-<10 K GAL CUMULATIVE PRO528522 Fatina Zareef Active, Exempt [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE F PR0532477 not assigned Inactive [ ] [ ] <br /> bw 1- 254 t,,7 2:--� i G,r,..@ \/� ' <br />