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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 11/26/2014 <br /> Submitted on: 11/18/2014 7:59:06AM CERS ID: 10181503 <br /> Submitted by: Matt Duaime Email: matt.duaime@stocktongov.com Facility ID in CERS: FA0003879 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0001176 <br /> Owner name CITY OF STOCKTON FIRE DEPARTMENT CITY OF STOCKTON FIRE DEPARTMENT 111 <br /> Mailing address 425 N ELDORADO ST 425 N ELDORADO ST 113 <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 114, 115, 11E <br /> Work phone 209-937-8801 (209)937-8801 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003879 <br /> Facility name STOCKTON CITY ENGINE CO#11 CITY OF STOCKTON FIRE STATION #11 3 <br /> Site address 1211 E SWAIN RD 1211 E SWAIN RD 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95210 95210 105 <br /> Facility phone 209-944-8271 (209) 937-8801 102 <br /> Facility mailing address 425 N EL DORADO ST RM 312 1211 E SWAIN RD 108a <br /> STOCKTON, CA 95202 STOCKTON, CA 95210 10eb, 10ec,toe <br /> BILLING INFORMATION <br /> Contact name STOCKTON CITY ENGINE CO#11 City of Stockton Fire Department 140 <br /> Address 425 N EL DORADO ST RM 312 425 N EL DORADO 143 <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 144, 145, 14c <br /> Contact phone 209-944-8271 (209) 937-8801 141 <br /> Contact email 142 <br /> Mail invoices to -dor Ml <br /> Program record [ HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: 0 s 3`14 3 Y. <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: 1c12i <br /> Assigned to: kAaza <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: f11 1 Date: 111 4 1-1 <br /> Accounting: Reviewed by: Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0232404 STEVE SASSON Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509793 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 2840-AST EXEMPT FAC < 1,320 GAL PR0528816 FATINAH ZAREEF Inactive [ ] [ ] <br />