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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11/7/2014 <br /> Submitted on: 10/13/2014 1:53:15112M CERS ID: 10504882 <br /> Submitted by: Kevin Myose Email: kmyose@sjgov.org Facility ID in CERS: FA0022365 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0018765 <br /> Owner name San Joaquin County San Joaquin County 111 <br /> Mailing address 444 S Wilson Way 444 S.Wilson Way 113 <br /> Stockton, CA 95205 Stockton, CA 95205 114, 115,116 <br /> Work phone 209-468-3099 209468-3099 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0022365 <br /> Facility name Agricultural Center Agricultural Center 3 <br /> Site address 2101 E EarhartAve 2101 E EarhartAve 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209468-3099 209468-3099 102 <br /> Facility mailing address 444 S Wilson Way 444 S.Wilson Way 108a <br /> Stockton, CA 95205 Stockton, CA 95205 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name Robyn Gilford David B. Myers 140 <br /> Address 444 S Wilson Way 444 S. Wilson Way 143 <br /> Stockton, CA 95205 Stockton, CA 95205 144, 145, 146 <br /> Contact phone 209-468-3099 209-468-9745 141 <br /> Contact email rgilford@sjgov.org dbmyers@sjgov.org 142 <br /> Mail invoices to FaKityP( <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: ( ] full calendar year [ ] prorate thiscalendaryear [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: /(`r Date: <br /> Accounting: Reviewed by: Date: Clerical: ] File [ ] Relabel file [ ] Create new file <br /> -- ------------------ <br /> [ ] Acc ed [ ] Surchar rl led B : Date: <br /> --—— ——— — ————— ---- -----------y- <br /> ------------ <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 Materials PRO538937 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0539228 STACY RIVERA Active [ ] [ ] <br />