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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/15/2014 <br /> Submitted on: 12/10/2014 3:33:09PM CERS ID: 10187851 <br /> Submitted by: Debbie Livermore Email: debbie.livermore@stocktongov.com Facility ID in CERS: FA0021386 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008643 <br /> Owner name CITY OF STOCKTOW MUD CITY OF STOCKTON- MUD 111 <br /> Mailing address 2500 NAW DR 2500 NAVY DR 113 <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 114, 115, 11E <br /> Work phone 209-937-8700 209-937-8700 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0021386 <br /> Facility name STOCKTON MUD WELLS-BUCKLEY COVE STOCKTON MUD WELLS-BUCKLEY COVE 3 <br /> Site address 3910 W MARCH LN 0 MARCH LN @ BUCKLEY COVE 103 <br /> City STOCKTON 104 <br /> ZIP code 95219 95219 105 <br /> Facility phone 209-937-8246 (209) 937-8246 102 <br /> Facility mailing address 2500 NAVY DR STOCKTON 2500 NAVY DR 108a <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 108b,108c,10E <br /> BILLING INFORMATION <br /> Contact name STOCKTON MUD WELLS-BUCKLEY COVE STOCKTON MUD WELLS-BUCKLEY COVE 140 <br /> Address 2500 NAVY DR 2500 NAVY DR 143 <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 144, 145, 14E <br /> Contact phone 209-937-8700 209-937-8700 141 <br /> Contact email 142 <br /> Mail invoices to Farility-A� <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 [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: /u-I Date: tj/r' 1-1 <br /> Accounting: Reviewed b : Date: 1 Clerical: <br /> y � [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] <br /> A59tb<ed [ ] Surchar erified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1926-HMBP-Unstaffed Network Location PRO537259 HAZA SAEED Active [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PRO528525 FATINAH ZAREEF Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO533313 not assigned Inactive [ ] [ ] <br />