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l <br /> SAN JOAQUIIOUNTY ENVIRONMENTAL HEALTHEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 7/8/2014 <br /> Submitted on: 2/28/2013 3:25:27PM CERS ID: 10187075 <br /> Submitted by: David Carter Email: dave.carter@ci.tracy.ca.us Facility ID in CERS: FA0019167 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0007811 <br /> Owner name TRACY, CITY OF TRACY, CITY OF 111 <br /> Mailing address 3900 HOLLY DR 3900 HOLLY DR 113 <br /> TRACY, CA 95304 TRACY, CA 95304 114, 115, 116 <br /> Work phone 209-831-4480 (209) 831-4480 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019167 <br /> Facility name WELL#5 WATER TREATMENT WELL#5 WATER TREATMENT 3 <br /> Site address 1050 TWELFTH ST 1050 TWELFTH ST 103 <br /> City TRACY TRACY 104 <br /> Zip code 95376 95376 105 <br /> Facility phone 209-831-6302 (209) 831-6302 102 <br /> Facility mailing address 3900 HOLLY DR- 6649 S Tracy BIVD 108a <br /> TRACY, CA 95304 TRACY, CA 95377 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name WELL#5 WATER TREATMENT WELL#5 WATER TREATMENT 140 <br /> Address 3900 HOLLY DR 3900 HOLLY DR 143 <br /> TRACY, Ce 95304 TRACY, CA 95304 144, 145, 146 <br /> Contact phone Not Specified N/A 141 <br /> Contact email 142 <br /> Mail invoices to FarAlty <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: Date: <br /> Accounting: Reviewed by:. Date: �L,��' Clerical.: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] 1 1 <br /> Ac�t�bllled [ ] Surc age ver`fied 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. PR0538247 MICHAEL PARISSI Active. [ ] [ ] <br /> 2840-AST EXEMPT FAC <1,320 GAL PR0528398 THUY TRAN Active,Exempt ( ] [ ] <br />