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"`SAN JOAQWOUNTY ENVIRONMENTAL HEAL T PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 7/2/2014 <br /> Submitted on: 211412013 11:58:13AM CERS ID: 10187045 <br /> Submitted by:boreen Rogers Email: jeffrogerstrucking@gmail.com Facility ID in CERS: FA0019053 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> (current EC database) (current submittal) field <br /> OWNER INFORMATION <br /> Owner ID OW0015681404 <br /> Owner name :ROGERS, JEFF DOREEN'RIGERS 111 <br /> Mailing address 3973 SUNNY RD 3973 SUNNY RD 113 <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 114, 115, 116 <br /> Work phone 209-944-9414 112 <br /> FACILITY FILE INFORMATION <br /> Facility I D FA0019053 <br /> Facility name JEFF ROGERS TRUCKING JEFF ROGERS TRUCKING 103 <br /> Site address 3973 SUNNY RD 3973 SUNNY RD <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95215 95215 105 <br /> Facility phone 209-944-9350 (209) 944-9414 102 <br /> Facility mailing address 3973 SUNNY RD P O BOX 30698 108a <br /> STOCKTON, CA 95215 STOCKTON, CA 95213 goat,108c,goad <br /> BILLING INFORMATION <br /> Contact name JEFF ROGERS TRUCKING JEFF TRUCKING 140 <br /> Address 3973 SUNNY RD P O BOOXX 30690fi98 <br /> STOCKTON, CA 95215 STOCKTONCA 95213 144, 145, 146 <br /> Contact phone 209-944-9350 209-944-9414 141 <br /> Contact email JEFFROGERSTRUCKING@GMAIL.COM 142 <br /> Mail invoices to Facility <br /> Program record [(j HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: fi-6 <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: 1 7 c7 <br /> Assigned to: <br /> Please bill: [ Mull calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> : U <br /> g <br /> Processed through CERS Integration Wizard by ;C Date: �- lJ� -- <br /> --- --- <br /> ___ _ ____ ____ -------------- <br /> —Accounting: Reviewed by: !Date: 7i2 I — Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> ] Acct billed [ ] Surcharge verified <br /> ------------- <br /> —— —— ——`————By------ Date--------——— <br /> ------ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Pro ram Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 2831 -AST FAC >I= 1,320-X10 K GAL CUMULATIVE PR0528142 ELENA MANZO Active, Exempt t ] I 1 <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE F PR053i464 not assigned Inactive I 1 I <br /> ir <br /> 25LI(0.�yS <br />