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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/21/2014 <br /> Submitted on: 1/29/2014 11:34:16AM CERS ID: 10181525 <br /> Submitted by: Ty Rust Email: ty.rust@stocktongov.com Facility ID in CERS: FA0003925 <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 CITY OF STOCKTON 111 <br /> Mailing address 2500 Navy Drive 425 N EL DORADO ST 113 <br /> STOCKTON, CA 95202-1997 STOCKTON, CA 95202 114, 115, 116 <br /> Work phone 209-937-8460 '` (209) 937-8341 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003925 <br /> Facility name COS MUNICIPAL SERVICE CTR COS MUNICIPAL SERVICE CTR 3 <br /> Site address 1465 S LINCOLN ST 1465 S LINCOLN ST 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 952061941 95206-1941 105 <br /> Facility phone 209-937-8341 (209) 937-8341 102 <br /> Facility mailing address 1465 S LINCOLN ST 1465 S LINCOLN ST 108a <br /> STOCKTON, CA 952061941 STOCKTON, CA 95206-1941 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name COS MUNICIPAL SERVICE CTR COS MUNICIPAL SERVICE CTR 140 <br /> Address 1465 S LINCOLN ST 1465 S LINCOLN ST 143 <br /> STOCKTON, CA 952061941 STOCKTON, CA 95206-1941 144, 145, 146 <br /> Contact phone 209-937-8377 (209)937-7582 141 <br /> Contact email DESERIE.SCHAFFER@STOCKTONGOV.( 142 <br /> Mail invoices to Facility P" <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year <br /> 1, _ w_II rr__ y [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: � A Date: (I j-1 ti q <br /> Accounting: Reviewed by:e_Date: /6//'tl Clerical: [/]/File [ ] Relabel file [ ] Create new file <br /> [ ] Ac Illed— ( ] Surc a e verified t By: Date: <br /> --——— —— <br /> ——————————————-----—— ———— —- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PRO519707 ROBERT LOPEZ Active [ ] [ ] <br /> 2217-APPLIANCE RECYCLER PRO521488 JEFFREY WONG Inactive [ ] [ ] <br /> 2227-GEN 5<25 TONS PERMIT PR0513893 STACY RIVERA Active [ ] [ ] <br /> 2301 -UST STATE SURCHARGE FEE PRO615554 STEVE SASSON Inactive [ ] [ ] <br /> 2361 -UST FACILITY PR0232272 STACY RIVERA Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509538 HAZ MAT SJC DES Inactive [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0528151 STACY RIVERA Active,Exempt [ ] [ ] <br /> 2950-ENVIRON ASSESS PRO505303 DIANE HINSON Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523840 HARPRIT MATTU Active [ ] [ ] <br />