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a in <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/25/2014 <br /> Submitted on: 6/1212014 12:57:52PM CERS ID: 10182691 <br /> Submitted by: Cynthia Adkisson Email: cadkisso@ebmud.com Facility ID in CERS: FA0009460 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0007460 <br /> Owner name East Bay Municipal Utility District East Bay Municipal Utility District 111 <br /> Mailing address PO BOX 24055 MS 704 PO BOX 24055 MS 704 113 <br /> 114, 115, 116 <br /> OAKLAND, CA 94623-1055 OAKLAND, CA 94623-1055 <br /> Work phone 209-946-8000 2099468000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009460 <br /> Facility name EAST BAY MUD Stockton Center- EBMUD 3 <br /> Site address 1804 W MAIN ST 1804 W MAIN ST 103 <br /> City STOCKTON STOCKTON / 104 <br /> Zip code 95203 95203 105 <br /> Facility phone 209-946-8000 (209)946-8000 102 <br /> Facility mailing address PO BOX 24055 -MS704 PO BOX 24055-MS704 108a <br /> OAKLAND, CA 94623-1055 OAKLAND, CA 94623-1055 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name EAST BAY MUD Stockton Center-EBMUD 140 <br /> Address PO BOX 24055-MS704 PO BOX 24055-MS704 143 <br /> OAKLAND, CA 94623-1055 OAKLAND, CA 94623-1055 144,145, 146 <br /> Contact phone 209-946-8000 2099468000 141 <br /> Contact email 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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 [ ] exempt from billing <br /> Processed through CERS Integration Wizard by:�—Date: (n•�.t -I <br /> _ -------------------------- <br /> Accounting: Reviewed by: Date: Clerical: File Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> --------------------------------------77 — --- <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 PR0519645 ROBERT LOPEZ Active [ 1 [ 1 <br /> 2220-SM HW GEN<5 TONS/YR PRO513851 STACY RIVERA Active I 1 [ I <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PRO501427 LETITIA BRIGGS Inactive [ 1 [ 1 <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO509460 HAZ MAT SJC DES Inactive I 1 [ 1 <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0528281 STACY RIVERA Active,Exempt [ ] [ 1 <br /> 4740-WASTE TIRE SITE-EXEMPT PRO524083 HARPRIT MATTU Active I 1 I 1 <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533459 not assigned Inactive [ 1 I 1 <br />