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SAN JOAQUh -COUNTY ENVIRONMENTAL HEALTH uEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/30/2014 <br /> Submitted on: 1/15/2014 10:11:36AM CERS ID: 10183799 <br /> Submitted by: Paula Wilson Email: paula@deckwest.com Facility ID in CERS: FA0010763 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008763 <br /> Owner name SHIPMAN, PATTY J SHIPMAN, PATTY J 111 <br /> Mailing address 1900 SANGUINETTI LN 3444 COUNTRY CLUB 113 <br /> STOCKTON, CA 95205 STOCKTON, CA 95204 114, 115, 116 <br /> Work phone 209-943-1094 (209) 943-1094 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010763 <br /> Facility name DECK WEST INC DECK WEST INC 3 <br /> Site address 1900 SANGUINETTI LN 1900 SANGUINETTI LN 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95205 95205 105 <br /> Facility phone 209-939-9700 (209) 939-9700 102 <br /> Facility mailing address 1900 SANGUINETTI LN 1900 SANGUINETTI LN 108a <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 108b,10ec,toad <br /> BILLING INFORMATION <br /> Contact name DECK WEST INC DECK WEST INC 140 <br /> Address 1900 SANGUINETTI LN 1900 SANGUINETTI LN 143 <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 144,145, 146 <br /> Contact phone Not Specified (209) 939-9700 141 <br /> Contact email SERINA@DECKWEST.COM 142 <br /> Mail invoices to Oyfer VA- <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 /> ---------------- <br /> Accounting: Reviewed Dater Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> Abilled [ ] Surc ge 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 /> 1920-HMBP-Common Materials PRO520473 HAZA SAEED Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510763 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE F PRO533100 not assigned Inactive [ ] l 1 <br />