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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/12/2014 <br /> Submitted on: 12/5/2014 10:23:40AM CERS ID: 10186283 <br /> Submitted by: Stan Shaw Email stan.mariashaw@yahoo.com Facility ID in CERS: FA0017333 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0014174 <br /> Owner name STANLEY E SHAW STANLEY E SHAW 111 <br /> Mailing address 22801 E STONE RD 22801 E STONE RD 113 <br /> ESCALON, CA 95320 ESCALON, CA 95320 114, 115, 11E <br /> Work phone (209) 838-2099 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017333 <br /> Facility name STANLEY E SHAW STANLEY E SHAW 3 <br /> Site address 22801 E STONE RD 22801 E STONE RD 103 <br /> City ESCALON 104 <br /> ZIP code 95320 95320 105 <br /> Facility phone 209-838-2099 (209) 838-2099 102 <br /> Facility mailing address 22801 E STONE RD ESCALON 22801 E STONE RD 108a <br /> ESCALON, CA 95320 ESCALON, CA 95320 108b, 108c, ICE <br /> BILLING INFORMATION <br /> Contact name STANLEY SHAW STANLEY SHAW 140 <br /> Address 2005 LA VILLA ROSE CT 22801 E STONE RD 143 <br /> MODESTO, CA 95350 ESCALON, CA 95320 144, 145, 144 <br /> Contact phone Not Specified (209) 838_2099 141 <br /> Contact email STAN.MAR IAS HAW@YAHOO.COM 142 <br /> Mail invoices to Owner flair <br /> Program record [ ] HMBP j ] 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: t" - Date: 0 to 1+f <br /> Accounting: Reviewed by: Date: 0� Clerical: j.] File [ ] Relabel file [ ] Create new file <br /> [ ] AS5,bftd [ ] Surchar ed By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1958-HM-Farm Operations PR0525518 not assigned Active [ ] [ ] <br /> 2,840-AST EXEMPT FAC E 1,320 GAL PR0530119 WILLY NG Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533805 not assigned Inactive [ ] [ ] <br />