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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 11/30/2015 <br />Submitted on: 11/24/2015 10:40:59AM CERS ID: 10187099 <br />Submitted by: Debbie Livermore Email: debbie.livermore@stocktongov.com Facility IP in CERS: FA0019198 <br />FA0019198 <br />Information prior to CIW processing <br />Information after CIW processing <br />CERS <br />OWNER INFORMATION <br />(current EC database) <br />(current submittal) <br />field <br />95219 <br />Number of Facilities for this Owner: 9 <br />209-837-8377 <br />STOCKTON, CA 95206 <br />Owner ID <br />OW0012870 <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PRO533454 not assigned <br />Inactive (] [ ] <br />Owner name <br />City of Stockton <br />CITY OF STOCKTON <br />111 <br />Mailing address <br />425 N. EI Dorado Street <br />425 N. EL DORADO STREET <br />113 <br />STOCKTON, CA 95202 <br />STOCKTON, CA 95202 <br />114, 115, 116 <br />Work phone <br />209-937-8341 <br />209-937-8341 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0019198 <br />Facility name <br />SPANOS WEST (FAKLIS PARK) <br />Site address <br />5250 COSUMNES DR <br />City <br />STOCKTON <br />ZIP code <br />95219 <br />Facility phone <br />209-837-8377 <br />Facility mailing address 2500 NAVY DR <br />STOCKTON, CA 95206 <br />BILLING INFORMATION <br />Contact name SPANOS WEST (FAKLIS PARK) <br />Address 2500 NAVY DR <br />STOCKTON, CA 95206 <br />Contact phone 209-937-8700 <br />Contact email <br />Mail invoices to Facility <br />SPANOS WEST (FAKLIS PARK) <br />3 <br />5250 COSUMNES DR <br />103 <br />STOCKTON <br />104 <br />95219 <br />105 <br />(209) 837-8700 <br />I <br />102 <br />2500 NAVY DR <br />108a <br />STOCKTON, CA 95206 <br />108b,108c, 1084 <br />CITY OF STOCKTON - MUD 140 <br />2500 NAVY DR 143 <br />STOCKTON, CA 95206 144, 145, 146 <br />209-937-8700 141 <br />142 <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 [ ] <br />next calendar year [ exempt from billing <br />Processed through CERS Integration Wizard by: ✓ Date: <br />-------------------------------------------------- <br />Accounting: Reviewed by: ( Date: )L 1 Clerical: <br />[ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified <br />By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name <br />Status Reactivated Inactivated <br />1926 - HMBP-Unstaffed Network Location PR0537207 HAZA SAEED <br />Active [ ] [ ] <br />2831 - AST FAC >/= 1,320 - <10 K GAL CUMULATIVE PR0528526 FATINAH ZAREEF <br />Inactive yfQ [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PRO533454 not assigned <br />Inactive (] [ ] <br />