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E- SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 2/20/2015 <br /> Submitted on: 1/15/2015 3:04:21PM CERS ID: 10183015 <br /> Submitted by: Rachelle Brown Email: rachelle_lfwmfg@yahoo.com Facility ID in CERS: FA0009906 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0007906 <br /> Owner name WICKHAM, LEO F WICKHAM, LEO F 111 <br /> Mailing address 745S LINCOLN ST 745 S LINCOLN ST 113 <br /> STOCKTON, CA 95203 STOCKTON, CA 95203 114, 115,116 <br /> Work phone 209465-0444 209-759-3832 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009906 <br /> Facility name LFW MFG INC LFW MFG INC 3 <br /> Site address 745 S LINCOLN ST 745 S LINCOLN ST 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95203 95203 105 <br /> Facility phone 209465-0444 (209)465-0444 102 <br /> Facility mailing address 745 S LINCOLN ST 745 S LINCOLN ST 108a <br /> STOCKTON, CA 95203 STOCKTON, CA 95203 108b, 108c load <br /> BILLING INFORMATION <br /> Contact name LFW MFG INC Rachelle Brown 140 <br /> Address 745 S LINCOLN ST / 745 S LINCOLN ST 143 <br /> STOCKTON, CA 95203 ✓ STOCKTON, CA 95203 144, 145, 146 <br /> Contact phone Not Specified 209.465-0444 141 <br /> Contact emaillfwmfg@yahoo.com 142 <br /> Mail invoices to <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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: 01*" Date: L-�a f7j <br /> ---- -- <br /> Accounting: Reviewed by: Date: 3 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> -------------------------------------------------- <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 PRO519950 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PRO509906 STACY RIVERA Active [ ] [ ] <br /> 2840-AST EXEMPT FAC <1,320 GAL PRO528489 STACY RIVERA Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533302 not assigned Inactive [ ] [ ] <br />