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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS integration Wizard <br /> Date run: 6/20/2014 <br /> Submitted on: 2112/2014 11:55:04AM CERS ID: 10180737 <br /> Submitted by: Kathy McGuinness Email: turnercut@comcast.net Facility ID in CERS: FA0001340 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0001045 <br /> Owner name TURNER CUT RESORT INC TURNER CUT RESORT INC 111 <br /> Mailing address 111 WESTMOOR DR 111 WESTMOOR DR 113 <br /> SANTA CRUZ, CA 95060 SANTA CRUZ, CA 95060 114, 115, 116 <br /> Work phone 408-482-1229 (831)429-1888 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0001340 <br /> Facility name TURNER CUT RESORT TURNER CUT RESORT 3 <br /> Site address 12888 W NEUGEBAUER RD 12888 W NEUGEBAUER RD 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95206 95206 105 <br /> Facility phone 209-465-4129 (209)465-4129 CAFE 102 <br /> Facility mailing address PO BOX 1281 PO BOX 1281 108a <br /> SANTA CRUZ, CA 95061 SANTA CRUZ, CA 95061 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name TURNER CUT RESORT TURNER CUT RESORT 140 <br /> Address PO BOX 1281 PO BOX 1281 143 <br /> SANTA CRUZ, CA 95061 SANTA CRUZ, CA 95061 144, 145, 146 <br /> Contact phone 831-429-1888 (831)429-1888 141 <br /> Contact email Turnercut@comcast.net 142 <br /> Mail invoices to Facility <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 <br /> o:Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: k l Z-Z <br /> Accounting: Reviewed by: Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Ac . ed [ ] Surcharswlverified By: ____ Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> x1624-RESTAURANT/BAR 21-50 SEATS PR0160788 MELISSA NISSIM Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PR0519577 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO509360 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PRO516783 STACY RIVERA Active, Exempt [ ] [ ] <br />