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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/21/2014 Submitted on: 3/5/2014 1:40:03PM CERS ID: 10181651 Submitted by: David Gorton Email: dgorton@sjgov.org Facility ID in CERS: FA0004518 Information prior to CIW processing Information after CIW processing CERS OWNER INFORMATION (current EC database) (current submittal) field Owner ID OW0000482 Owner name SJC PUBLIC WORKS San Joaquin County 111 Mailing address PO BOX 1810 PO BOX 1810 STOCKTON, CA 95201 STOCKTON, CA 95201 114, 1 53116 Work phone 209-468-3066 (209)468-3066 112 FACILITY FILE INFORMATION Facility ID FA0004518 Facility name NORTH COUNTY LANDFILL NORTH COUNTY LANDFILL 3 Site address 17720 E HARNEY LN 17720 E HARNEY LN 103 City LODI LODI 104 Zip code 95240 95240 105 Facility phone 209-468-3066 (209)468-3066 102 Facility mailing address PO BOX 1810 PO BOX 1810 108a STOCKTON, CA 95201 STOCKTON, CA 95201 108b,108c,108d BILLING INFORMATION Contact name SJC PUBLIC WORKS San Joaquin County 140 Address PO BOX 1810 PO BOX 1810 143 STOCKTON, CA 95201 STOCKTON, CA 95201 144, 145, 146 Contact phone Not Specified (209)468-3066 141 Contact email 142 Mail invoices to Facility Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PRM created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [/] next calendar year [ ] exempt from billing Processed through CERS Integration Wizard by:_)��Date: r/ '7, 1 — ———g. ———— Y -- — ----- ----- — ——— ——- Accountin Reviewed by:e—Date:J� Clerical: [ ] File [ ] Relabel File [ ] Create new file ------------------[ ] Acc,f�ifred [ ] Surchar—_rifle ------ _—By:--- Date ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Program Element and Description Record ID Employee name Status Reactivated Inactivated 1921 -HMBP-Regular-Primary Location PRO512560 JAMIE DE LA ROSA Active [ ] [ ] 2217-APPLIANCE RECYCLER PR0523556 ARTS VELOSO Active [ ] [ ] 2218-CRT HANDLER PR0518299 ARIS VELOSO Active [ ] [ ] 2227-GEN 5<25 TONS PERMIT PR0523369 ARIS VELOSO Active [ ] [ ] 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510272 HAZ MAT SJC DES Inactive [ ] [ ] 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PRO523381 ARIS VELOSO Active, Exempt [ ] [ ] 4433-LANDFILL DISPOSAL SITE PRO440058 ROBERT MCCLELLON Active [ ] [ ] J4740-WASTE TIRE SITE-EXEMPT PR0523816 NATALIA SUBBOTNIKOVA Active [ ] [ ]