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E:::- SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11124/2014 <br /> Submitted on: 11/18/2014 7:24:08AM <br /> Submitted by: Matt Duaime Email: matt.duaime@stocktongov.com CERS 10187209 <br /> Facility ]Din CERSRS: FA0019317 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0001176 <br /> Owner name CITY OF STOCKTON FIRE DEPARTMENT CITY OF STOCKTON FIRE DEPARTMENT 111 <br /> Mailing address 425 N ELDORADO ST 425 N EL DORADO ST <br /> STOCKTON, CA 95202STOCKTON, CA 95202 114, 115311E <br /> Work phone 209-937-8801 (209) 937-8801 <br /> 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019317 <br /> Facility name STOCKTON FIRE STATION #13 CITY OF STOCKTON FIRE STATION #13 3 <br /> Site address 3606 HENDRIX DR 3606 HENDRIX DR 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95212 95212 105 <br /> Facility phone 209-937-8377 (209) 337-8801 102 <br /> Facility mailing address 425 N ELDORADO ST 3606 HENDRIX DR 108a <br /> STOCKTON, CA 95202 STOCKTON, CA 95212 1084, 108c,10E <br /> BILLING INFORMATION <br /> Contact name STOCKTON FIRE STATION #13 CITY OF STOCKTON FIRE DEPARTMENT 140 <br /> Address 425 N EL DORADO ST 425 N EL DORADO ST 143 <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 144, 145, 14f <br /> Contact phone Not Specified (209) 937-8801 141 <br /> Contact email 142 <br /> Mail invoices to F-aciiity - <br /> Program record j ] 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 this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: PYT Date: <br /> Accounting: Reviewed by: Date: 19 4114� Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acclbs11"ed [ ] erifie Surcha <br /> _�� By: Date: <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 PRO537249 HAZA SAEED Active, Exempt ( ] ( ] <br /> 2840-AST EXEMPT FAC = 1,320 GAL PRO528817 FATINAH ZAREEF Inactive [ ] ( ] <br />