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SAN JOAQU.-mCOUNTY ENVIRONMENTAL HEALTH-vEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 1/512015 <br /> Submitted on: 12/17/2014 3:07:37PM CERS ID: 10187835 <br /> Submitted by: Debbie Livermore Email: debbie.livermore@stocktongov.com Facility ID in CERS: FA0021377 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> (current EC database) (current submittal) field <br /> OWNER INFORMATION <br /> Owner ID OW0008643 111 <br /> NAVY <br /> Owner name CITY OF STOCKTON- MUD CITY NA 113 <br /> DR STOCKTON- MUD <br /> Mailing address 2500 NAVY DR 2500 <br /> 11a, 115, 11s <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> Work phone 209-937-8700 209-937-8700 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0021377 3 <br /> Facility name CITY OF STOCKTON- MUD CITY OF STOCKTON- MUD 103 <br /> Site address HORTON AVE NORTON AVE <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209-937-8246 (209) 937-8246 102 <br /> Facility mailing address 2500 NAVY DR 2500 NAVY DR 108a <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name CITY OF STOCKTON- MUD CITY OF STOCKTON- MUD 140 <br /> Address 2500 NAVY DR 2500 NAVY DR 143 <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 144, 145, 146 <br /> Contact phone 209-937-8700 209-937-8700 141 <br /> Contact email 142 <br /> Mail invoices to Facility <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 this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: l• -t <br /> Accounting: Reviewed by: Date: Clerical: File [ ] Relabel file [ ] Create new file <br /> ] Acct billed ( ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1926-HMBP-Unstaffed Network Location PR0537250 ROBERT LOPEZ Active [ l 1 <br />