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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/7/2015 <br /> Submitted on: 1/5/2015 2:23:41 PM CERS ID: 10183049 <br /> Submitted by: Scott Waller Email: scott.waller@dot.ca.gov Facility ID in CERS: FA0009942 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0001008 <br /> Owner name State of California/Department of Transports CALTRANS/DISTRICT 10 111 <br /> Mailing address 1976 East Charter Way PO BOX 2048 113 <br /> Stockton, CA 95205 STOCKTON, CA 95201 114, 115, 11E <br /> Work phone 209-948-7556 209-948-3723 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009942 <br /> Facility name CAL TRANS (LINCOLN ST) CAL TRANS (LINCOLN ST) 3 <br /> Site address 312 S LINCOLN ST 312 S LINCOLN ST 103 <br /> City STOCKTON 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209-948-7109 (209) 948-7109 102 <br /> Facility mailing address 312 S Lincoln ST STOCKTON 312 S Lincoln ST 108a <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 108b,1080,10E <br /> BILLING INFORMATION <br /> Contact name Scott Waller Scott Waller 140 <br /> Address PO BOX 2048 PO BOX 2048 143 <br /> STOCKTON, CA 95201 STOCKTON, CA 95201 144, 145, 14f <br /> Contact phone 209-948-3723 209-948-3723 141 <br /> Contact email scott.waller@dot.ca.gov scott.waller@dot.ca.gov 142 <br /> Mail invoices to Owaec +C- <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] 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 <br /> /Izby: ///r Date: iml <br /> Accounting: Reviewed by: Date: 119116 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 /> 1921 -HMBP-Regular-Primary Location PRO520348 ROBERT LOPEZ Active [ ] ( ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0523809 Garrett Alias-Backus Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0517886 STACY RIVERA Inactive [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0231157 MICHAEL KITH Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509942 HAZ MAT SJC DES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO533049 not assigned Inactive [ ] [ ] <br />