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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/5/2015 <br /> Submitted on: 12/30/2014 10:59:26AM CERS ID: 10180549 <br /> Submitted by: Tony Munoz Email: tmunoz@lodiusd.net Facility ID in CERS: FA0000196 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000031 <br /> Owner name LODI UNIFIED SCHOOL DISTRICT LODI UNIFIED SCHOOL DISTRICT 111 <br /> Mailing address 1305 E VINE ST 1305 E VINE ST 113 <br /> LODI, CA 95240 LODI, CA 95240 114, 115, 11E <br /> Work phone 209-331-7179 (209)331-7000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FAD000196 <br /> Facility name LODI USD-TOKAY HIGH SCHOOL LODI USD-TOKAY HIGH SCHOOL 3 <br /> Site address 1111 CENTURY BLVD 1111 CENTURY BLVD 103 <br /> City LODI 104 <br /> ZIP code 95240 95240 105 <br /> Facility phone 209-331-7991 (209) 331-7991 102 <br /> Facility mailing address 1305 E VINE ST LODI 1305 E VINE ST 108a <br /> LODI, CA 95240 LODI, CA 95240 108b,108c,me <br /> BILLING INFORMATION <br /> Contact name LODI USD-TOKAY HIGH SCHOOL LODI USD-TOKAY HIGH SCHOOL 140 <br /> Address 1305 E VINE ST 1305 E VINE ST 143 <br /> LODI, CA 95240 LODI, CA 95240 144, 145, 14( <br /> Contact phone 209-331-7914 209-331-7914 141 <br /> Contact email 142 <br /> Mail invoices to Owner/j <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: [ j full calendar year [ ] prorate this calendar year [ ] next calendarear <br /> y [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: /il-i Date: i4 /15 <br /> Accounting: Reviewed by: Date: 3f)5 Clerical: [ ] File [ ] Relabel file [ j 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 /> 1632-EXEMPT FOOD PRO160234 NICHOLAS WIESEMAN Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PRO519405 JAMIE DE LA ROSA Active [ I [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0522660 ARIS VELOSO Active [ ] [ ] <br /> 3616-PUBLIC POOL/SPA-EXEMPT PR0360147 NICHOLAS WIESEMAN Active [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0502798 FATINAH ZAREEF Inactive [ ] ( ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO509130 HAZ MAT SJC DES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532785 not assigned Inactive [ ] [ ] <br />