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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 4/3/2015 <br /> Submitted on: 2/3/2015 7:40:34AM CERS ID: 10187661 <br /> Submitted by: Lisa Acevedo Email: lisa.acevedo@faa.gov Facility ID in CERS: FA0020672 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008208 <br /> Owner name FEDERAL AVIATION ADMIN FEDERAL AVIATION ADMIN 111 <br /> Mailing address 7434 S Lindbergh St 11025 TRADE CENTER DR 113 <br /> Stockton, CA 95206 RANCHO CORDOVA, CA 95670 114, 115, 116 <br /> Work phone 209-234-1090 208-946-6310 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0020672 <br /> Facility name FEDERAL AVIATION ADMINISTRATION FEDERALAVIATION ADMINISTRATION 3 <br /> Site address 6580 LINDBERGH ST 6580 LINDBERGH ST STE B 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209-946-6310 209-946-6310 102 <br /> Facility mailing address 7434 S LINDBERGH ST 7434 S LINDBERGH ST 108a <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 108b,109c,108d <br /> BILLING INFORMATION <br /> Contact name FEDERALAVIATION ADMINISTRATION FEDERALAVIATION ADMINISTRATION 140 <br /> Address 7434 S LINDBERGH ST r/ 7434 S LINDBERGH ST 143 <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 144, 145,146 <br /> Contact phone 209-946-6310 209-946-6310 141 <br /> Contact email jamess.t� f� <br /> cup@faa.gov A ✓ james.tincup@faa.gov 142 <br /> me <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: 1X16-1 Date: 4-3'Iti <br /> -- --- --- - - ------------ ---------------- <br /> Accounting: Reviewed by: Date: S-�y S 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 PR0539109 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0535905 ELENA MANZO Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0535906 not assigned Inactive [ ] [ ] <br />