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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/2/2014 <br /> Submitted on: 11/25/2014 1:37:1113M CERS ID: 10183125 <br /> Submitted by: Stanley Seifert Email: seifert@softcom.net Facility ID in CERS: FA0010018 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008018 <br /> Owner name STANLEY D SEIFERT STANLEY D SEIFERT 111 <br /> Mailing address 9450 E COLLIER RD 9450 E COLLIER RD 113 <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 114, 115, 11E <br /> Work phone 209-367-0850 209-367-0850 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010018 <br /> Facility name SO SEIFERT CO SD SEIFERT CO 3 <br /> Site address 9450 E COLLIER RD 9450 E COLLIER RD 103 <br /> City ACAMPO ACAMPO 104 <br /> ZIP code 95220 95220 105 <br /> Facility phone 209-367-0850 (209) 367-0850 102 <br /> Facility mailing address 9450 E COLLIER RD 9450 E COLLIER RD 108a <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 108b, 1080,10E <br /> BILLING INFORMATION <br /> Contact name SO SEIFERT CO SO SEIFERT CO 140 <br /> Address 9450 E COLLIER RD 9450 E COLLIER RD 143 <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 144, 145, 14f <br /> Contact phone Not Specified 209-367-0850 141 <br /> Contact e - <br /> Mail invoices to Ear®ifily142 <br /> Program recon! ( ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created r Tiered permit [ ] APSA [ ] CaIARP [ ] 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: �/V-1 Date: <br /> Accounting: Reviewed by:_ SC Date: Z5 [1�{ Clerical: File [ ] Relabel file [ ] Create new file <br /> ( ] <br /> AWAbiflecl [ ] Sur ge 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 /> 1920-HMBP-Common Material, PR0520026 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSlYR PR0517916 ARTS VELOSO Active [ ] ( ] <br /> 2830-AST FAC -SPCC EXEMPT PR0529322 ARIS VELOSO Active [ ] [ ] <br /> 4740-WASTE TI RE SITE -EX E',1PT PR0528069 HARPRIT MATTU Active [ ] [ ] <br /> 1958-HM-Farm Operations PRO524838 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510018 HAZ MAT SJC OES Inactive [ ] ( ] <br /> ERSC-ELECTRONIC REPORT!^JG STATE SURCHARGE FI PRO533462 not assigned Inactive [ ] [ ] <br />