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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 12/16/2016 <br /> CERS ID: 10187851 <br /> Submitted on: 12/6/2016 4:31:42PM Facility ID in CERS: FA0021386 <br /> Submitted by: Debbie Livermore Email: debbie.livermore@stocktongov.com tY FA0021 <br /> Information prior to CIW processing Information after CIW processingfield <br /> S <br /> (current EC database) (current submittal) <br /> OWNER INFORMATION Number of Facilities for this Owner : 70 <br /> Owner ID OW0008643 CITY OF STOCKTON 111 <br /> Owner name CITY OF STOCKTON 113 <br /> Mailing address 425 N. ELDORADO STREET 425 N. ELDORADO tta 115, Its <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 112 <br /> Work phone 209-937-8341 209-937-8341 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0021386 3 <br /> Facility name Buckley Cove Buckley Cove <br /> Site address 3910 W March Ln 3910 W March Ln 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95219 95219 105 <br /> Facility phone 209-937-8700 (209) 937-8700 102 <br /> Facility mailing address 2500 NAVY DR 2500 NAVY DR 108a <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 108b.108c.1084 <br /> BILLING INFORMATION <br /> Contact name CITY OF STOCKTON - MUD CITY OF STOCKTON - MUD 140 <br /> Address 2500 NAVY DR 2500 NAVY DR 143 <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 144, 145, 146 <br /> Contact phone 209-937-8700 209-937-8700 141 <br /> Contact email 142 <br /> Mail invoices to Account <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 <br /> 1this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: W_�"Date: 1 k-I lo-1(w <br /> Accounting: Reviewed by: I/J Date: 1-2-11 y I I [C ' Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1920-HMBP-Common Materials 1 chem units PR0537259 HAZA SAEED Active [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0528525 ARIS VELOSO Active, Exempt [ j <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533313 not assigned Inactive [ ] [ ] <br />