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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 1/25/2016 <br />Submitted on: 1/12/2016 3:33:27PM CERS ID: 10187801 <br />Submitted by: Greg Clark Email: gclark@lodistorage.com Facility ID in CERS: FA0021352 <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner : 7 <br />OW0010696 <br />LODI GAS STORAGE LLC <br />PO BOX 230 <br />ACAMPO, CA 95220 <br />209-368-9277 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0021352 <br />Facility name <br />LGS Well Pad 4 <br />Site address <br />8611 E JAHANT RD <br />City <br />ACAMPO <br />ZIP code <br />95220 <br />Facility phone <br />209-368-9277 <br />Facility mailing address <br />PO BOX 230 <br />ACAMPO, CA 95220 <br />BILLING INFORMATION <br />Contact name <br />LODI GAS STORAGE LLC -WELL PAD 4 <br />Address <br />PO BOX 230 <br />ACAMPO, CA 95220 <br />Contact phone <br />209-368-9277 <br />Contact email <br />Mail invoices to <br />Account <br />Information after CIW processing CERS <br />(current submittal) field <br />LODI GAS STORAGE LLC 111 <br />PO BOX 230 113 <br />ACAMPO, CA 95220 114, 115, 116 <br />2093689277 112 <br />LGS Well Pad 4 <br />3 <br />8611 E JAHANT RD <br />103 <br />ACAMPO <br />104 <br />95220 <br />105 <br />(209) 368-9277 <br />102 <br />PO BOX 230 <br />108a <br />ACAMPO, CA 95220 <br />108b, 108c, 108d <br />LODI GAS STORAGE LLC -WELL PAD 4 140 <br />PO BOX 230 143 <br />ACAMPO, CA 95220 144, 145, 146 <br />2093689277 141 <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate <br />tthis <br />'calendar year [ ] ►next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: CNV Date: <br />Accounting: Reviewed by: L4� 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 PR0537196 JAMIE DE LA ROSA Inactive` [ ] <br />