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SAN JOAQUIN tOUNTY ENVIRONMENTAL HEALTH DEPARTMENT AK-� <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 7/2/2014 <br /> Submitted on: 3/15/2014 5:18:17PM CERS ID: 10187291 <br /> Submitted by: Karen Eagal Email: karen@eagallakes.com Facility ID in CERS: FA0019664 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0016121 <br /> Owner name JOHN EAGAL JOHN EAGAL 111 <br /> Mailing address 10820 LAKEMORE LN 4719 Quail Lakes Dr, Ste G PMB 332 113 <br /> STOCKTON, CA 952197195 STOCKTON, CA 95207 114, 115, 116 <br /> Work phone 209-481-1614 209-481-1614 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019664 <br /> Facility name EAGAL LAKES SPORT RESORTS EAGAL LAKES SPORT RESORTS 3 <br /> Site address 12 W LORENZEN RD 12 W LORENZEN RD 103 <br /> City TRACY TRACY 104 <br /> Zip code 95304 95304 105 <br /> Facility phone 209-481-1614 (209)481-1614 0 102 <br /> Facility mailing address 10820 LAKEMORE LN 10820 LAKEMORE LN 108a <br /> STOCKTON, CA 952197195 STOCKTON, CA 95219-7195 108b,1081,load <br /> BILLING INFORMATION <br /> Contact name JOHN EAGAL JOHN EAGAL 140 <br /> Address 9132 SANDRINGHAM CT 4719 Quail Lakes Dr. Ste G PMB 332 143 <br /> STOCKTON, CA 95209 STOCKTON, CA 95207 144, 145, 146 <br /> Contact phone Not Specified 209-181-1614 141 <br /> Contact email 142 <br /> Mail invoices to Owner <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 by: Date: <br /> Accounting: Reviewed by: Date:�ZjW Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> I <br /> [ ] Iled [ ] Surchar---ie------_ ---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 /> 1920-HMBP-Common Materials PR0529827 MICHAEL PARISSI Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE F PR0533496 not assigned Inactive [ ] [ ] <br />