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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 6/10/2016 <br />Submitted on: 4/20/2016 10:16:40AM <br />Submitted by: Ben Guzman Email: bguzman@sjgov.org <br />CERS ID: 10669231 <br />Facility ID in CERS: incorrect <br />Information prior to CIW processing <br />Information after CIW processing <br />CERS <br />OWNER INFORMATION <br />(current EC database) <br />(current submittal) <br />field <br />Lodi <br />Number of Facilities for this Owner : 20 <br />ZIP code 95242 <br />95242 <br />Owner ID <br />OW0008853 <br />2094683090 <br />102 <br />Owner name <br />San Joaquin County <br />San Joaquin County <br />111 <br />Mailing address <br />1702 E. Scotts St <br />1702 E. Scotts <br />113 <br />Stockton, CA <br />Stockton, CA <br />114, 115, 116 <br />Work phone <br />Not Specified <br />2094683090 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID FA0023395 <br />Facility name SJC PUBLIC WORKS/UTILITY - FLAG CIT` <br />Flag City Well #3 <br />3 <br />Site address 15184 N THORNTON RD <br />15184 N Thornton Rd <br />103 <br />City LODI <br />Lodi <br />104 <br />ZIP code 95242 <br />95242 <br />105 <br />Facility phone Not Specified <br />2094683090 <br />102 <br />Facility mailing address 1702 E SCOTTS AVE <br />1702 E. Scotts <br />108a <br />STOCKTON, CA 95205 <br />Stockton, CA <br />108b, 108c, 1084 <br />BILLING INFORMATION <br />Contact name SJC PUBLIC WORKS/UTILITY-FLAG CITY <br />San Joaquin County <br />140 <br />Address 1702 E SCOTTS AVE <br />1702 E. Scotts <br />143 <br />STOCKTON, CA 95205 <br />Stockton, CA <br />144, 145, 146 <br />Contact phone 209-468-3090 <br />2094683090 <br />141 <br />Contact email <br />142 <br />Mail invoices to Facility <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ <br />] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ <br />] UST New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate is calendar year <br />[ ] next calendar year [ <br />] exempt from billing <br />Processed through CERS Integration Wizard by: Date: <br />0�/to/l (0 <br />Accounting: Reviewed by: (, Date: l���s i Clerical: [ ] File [ ] Relabel <br />file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified <br />By: <br />Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name Status <br />Reactivated Inactivated <br />1926 - HMBP-Unstaffed Network Location PR0540896 JAMIE LIMA <br />Active <br />I I I I <br />