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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Changes to EnvisionConnect by CERS Integration Wizard Date run: 1/14/2016 Submitted on: 1/13/2016 11:56:58AM Submitted by: Debbie Livermore Email: debbie.livermore@stocktongov.com OWNER INFORMATION Owner ID Owner name Mailing address Work phone Information prior to CIW processing (current EC database) j Number of Facilities for this Owner : 1 OW0019895 CITY OF STOCKTON-MUD 2500 NAVY DR STOCKTON, CA 95206 209-937-8700 FACILITY FILE INFORMATION Facility ID FA0022464 Facility name DWSP River Intake Site address 10001 N CORREIA RD City Stockton ZIP code 95219 Facility phone 209-937-8700 Facility mailing address 2500 NAVY DR STOCKTON, CA 95206 BILLING INFORMATION Contact name CITY OF STOCKTON-MUD Address 2500 NAVY DR STOCKTON, CA 95206 Contact phone 209-937-8700 Contact email Mail invoices to Facility CERS ID: 10424335 Facility ID in CERS: FA0022464 Information after CIW processing CERS (current submittal) field CITY OF STOCKTON 111 425 N. ELDORADO ST. 113 STOCKTON, CA 95202 114, 115, 116 209-937-8341 112 DWSP River Intake 3 10001 N Correia Rd 103 Stockton 104 95219 105 209-937-8700 102 2500 NAVY DR 108a STOCKTON, CA 95206 108b, 108c, 108d CITY OF STOCKTON-MUD 140 2500 NAVY DR 143 STOCKTON, CA 95206 144, 145, 146 209-937-8700 141 142 Program record [ ] HMBP [ ] SOG HW [ ] LQG HW [ ] RCRA HW created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PR#: _ New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing Processed through CERS Integration/ nW,izard by: Date: Accounting: Reviewed by: Date: [ S/1 Clerical: [ ] File [ ] Relabel file [ ] Create new file [ ] Acct billed [ ] Surcharge verified By: Date: ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Program Element and Description Record ID Employee name Status Reactivated Inactivated 1920 - HMBP-Common Materials PR0539281 HAZA SAEED Active [ ] [ ] 2831 - AST FAC >/= 1,320 - <10 K GAL CUMULATIVE PR0539476 FATINAH ZAREEF Active [ ] [ ]