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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 121212014 <br /> Submitted on: 11/25/2014 1:37:11PM CERS ID: 10183125 <br /> Submitted by: Stanley Seifert Email: seifert@softcom.net Facility ID in CERS: FA0010018 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008018 <br /> Owner name STANLEY D SEIFERT STANLEY D SEIFERT 111 <br /> Mailing add: 9450 E COLLIER RD 9450 E COLLIER RD 113 <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 114, 115, 11E <br /> Work phone 209-367-0850 209-367-0850 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010018 <br /> Facility name SD SEIFERT CO SD SEIFERT CO 3 <br /> Site address 9450 E COLLIER RD 9450 E COLLIER RD 103 <br /> ACAMPO ACAMPO 104 <br /> ZIP code 95220 95220 105 <br /> Facility phone 209-367-0850 (209) 367-0850 102 <br /> Facility mailing address 94.50 E COLLIER RD 9450 E COLLIER RD 108a <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 108b,108c.10E <br /> BILLING INFORMATION <br /> Contact nai; r SD SEIFERT CO SD SEIFERT CO 140 <br /> Address 9450 E COLLIER RD 9450 E COLLIER RD 143 <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 144, 145, 144 <br /> Contact phony. Not Specified 209-367-0850 141 <br /> Contact 0j,,_. <br /> Mail invoices to Fitrj✓ 142 <br /> Program recon! [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created r 7 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 CL"'S Integration Wizard by: 1, Date: <br /> Accounting: Reviewed by: — Date: Clerical: File [ ] Relabel file ( ] Create new file <br /> [ ] Aflled ( ] Sur ge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1920-HMBP-Coni non Matena,n PR0520026 JAMIE,DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TUNSh iI PRO517916 ARIS VELOSO Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PRO529322 ARIS VELOSO Active [ ] [ ] <br /> 4740-WASTE TIRE SITE -E:;;:'IPT PR0528069 HARPRIT MATTU Active ( ] [ ] <br /> 1958-HM-Farm Operations PR0524838 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510018 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORT'IG ST.',TE SURCHARGE FI PR0533462 not assigned Inactive [ ] [ ] <br />