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fSAN:JO7AQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> nges to EnvisionConnect by CERS Integration Wizard <br /> Date run: 2/212017 <br /> Submitted on: 1/20/2017 9:15:13AM CERS ID: 10181145 <br /> Submitted by: Don Cloward Email: firstclassyacht@sbcglobal.net Facility ID in CERS: FA0019257 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 1 <br /> Owner ID OW0015808 <br /> Owner name CLOWARD, DON CLOWARD, DON 111 <br /> Mailing address 5519 BROOK FALLS CT 5519 BROOK FALLS CT 113 <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 114, 115. 116 <br /> Work phone 209-810-3691 209 810-3691 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019257 <br /> Facility name FIRST CLASS YACHT FIRST CLASS YACHT 3 <br /> Site address 6651 EMBARCADERO DR 6651 EMBARCADERO DR 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95219 95219 105 <br /> Facility phone 209-951-1233 (209) 951-1233 102 <br /> Facility mailing address 6651 EMBARCADERO DR 6651 EMBARCADERO DR 108a <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name FIRST CLASS YACHT FIRST CLASS YACHT 140 <br /> Address 6651 EMBARCADERO DR 6651 EMBARCADERO DR 143 <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 144, 145, 146 <br /> Contact phone 209-810-3691 209 810-3691 141 <br /> Contact email 142 <br /> Mail invoices to Account <br /> Program record HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: e-0 S --I l b b <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: lL9 2-fl <br /> Assigned to: t.oP� L <br /> Please bill: full calendar year [ ] prorate <br /> ,,this <br /> rrcalendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: "2—' Z- ' l 1 <br /> Accounting: Reviewed by: � Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ cct billed� Lt`84urcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 2220-SM HW GEN<5 TONSIYR PR0528679 AARON HANG Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532256 not assigned Inactive [ ] { ] <br /> �q 162- <br />