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SAN JOAQ6 _ BOUNTY ENVIRONMENTAL HEALTh. jEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 8/11/2014 <br />Submitted on: 7/22/2014 4:48:54PM CERS ID: 10187119 <br />Submitted by: Dameon Flores Email: dflores@ci.lathrop.ca.us Facility ID in CERS: FA0019219 <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />OW0015531 <br />CITY OF LATHROP <br />390 TOWNE CENTRE DR <br />LATHROP, CA 95330 <br />209-941-7200 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0019219 <br />Facility name <br />LATHROP BOOSTER PUMP STATION #2 <br />Site address <br />18300 HOWLAND RD <br />City <br />LATHROP <br />Zip code <br />95330 <br />Facility phone <br />209-941-7200 <br />Facility mailing address <br />390 TOWN CENTER DR <br />LATHROP, CA 95330 <br />BILLING INFORMATION <br />Contact name LATHROP BOOSTER PUMP STATION #2 <br />Address 390 TOWN CENTER DR <br />LATHROP, CA 95330 <br />Contact phone 209-941-7200 <br />Contact email <br />Mail invoices to Facility <br />Information after CIW processing CERS <br />(current submittal) field <br />CITY OF LATHROP 111 <br />390 TOWNE CENTRE DR 113 <br />LATHROP, CA 95330 114, 115, 116 <br />(209) 941-7430 112 <br />LATHROP BOOSTER PUMP STATION #2 3 <br />18300 HOWLAND RD 103 <br />LATHROP 104 <br />95330 105 <br />(209) 941-7430 102 <br />390 TOWNE CENTRE DR 108a <br />LATHROP, CA 95330 <br />108b, 108c, 108d <br />New PE: <br />Assigned to: <br />140 <br />CTOWNEENTRE DR <br />143 <br />95330 <br />144,145,146 <br />141 <br />[File [ ] Relabel file [ ] Create new file <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] <br />next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: Date: <br />------------------------------------------------------ <br />Accounting: Reviewed by: V_T Date: Clerical: <br />[File [ ] Relabel file [ ] Create new file <br />[ ] Acql4ifed [ ] Surch verified <br />----- — - - — -- — — <br />By: Date: <br />------- <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name <br />Status Reactivated Inactivated <br />1926 - HMBP-Unstaffed Network Location PR0537188 MICHAEL PARISSI <br />Active [ ] [ ] <br />2840 - AST EXEMPT FAC < 1,320 GAL PR0528590 THUY TRAN <br />Inactive [ ] [ ] <br />