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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 5/5/2017 <br />Submitted on: 3/2/2017 8:25:55AM <br />Submitted by: Bill Cooper Email: bcooper@lodi.gov <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 />Number of Facilities for this Owner : 1 <br />OW0022470 <br />City og Lodi <br />PO BOX 3006 <br />Lodi, CA <br />209-333-6800 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0024003 <br />Facility name <br />Lodi City Well 11 R <br />Site address <br />824 E Turner Rd <br />City <br />Lodi <br />ZIP code <br />95240 <br />Facility phone <br />209-333-6800 <br />Facility mailing address 1331 S. Ham Ln <br />Lodi, CA 95240 <br />BILLING INFORMATION <br />Contact name City og Lodi well 11 R <br />Address 1331 S. Ham Ln <br />Lodi, CA 95240 <br />CERS ID: 10725925 <br />Facility ID in CERS: incorrect <br />Information after CIW processing CERS <br />(current submittal) field <br />City og Lodi <br />111 <br />PO BOX 3006 <br />113 <br />Lodi, CA <br />114, 115, 116 <br />2093336800 <br />112 <br />Lodi City Well 11 R 3 <br />824 E Turner Rd 103 <br />Lodi 104 <br />95240 105 <br />2093336800 102 <br />1331 S. Ham Ln 108a <br />Lodi, CA 95240 108b, 108c, 1084 <br />City og Lodi well 11 R 140 <br />1331 S. Ham Ln 143 <br />Lodi, CA 95240 144, 145, 146 <br />Contact phone 209-333-6800 2093336800 141 <br />Contact email 142 <br />Mail invoices to Account <br />Program record [°aj HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br />Assigned to: <br />Please bill: [vffull calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: 13rv\ 4�— Date: 5- L7 <br />Accounting: Reviewed by: Date: 5l V Clerical: [ ] File [ ] Relabel file <br />[ �cct billed Surcharge verified By: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status <br />1921 - HMBP-Regular-Primary Location i chem units PR0541854 JAMIE LIMA Active <br />N2 (-, D w,/�er t 'l � l�� ren �C� � �� ►"'1 �r9r►.� � �5 5 � � ��(�,n�1 �T <br />[ ] Create new file <br />Date: <br />Reactivated Inactivated <br />