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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTh jEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 8/12/2015 <br /> Submitted on: 8/5/2015 11:27:28AM CERS ID: 10181471 <br /> Submitted by: Dale Klever Email: dale.klever@ci.tracy.ca.us Facility ID in CERS: FA0003837 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0002807 <br /> Owner name TRACY, CITY OF TRACY, CITY OF 111 <br /> Mailing address 3900 HOLLY DR 3900 HOLLY DRIVE 113 <br /> TRACY, CA 95304 TRACY, CA 95304-1618 114, 115, 116 <br /> Work phone 209-831-4480 (209) 831-4480 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003837 <br /> Facility name TRACY WASTEWATER TX PLNT-MAINTEI TRACY WASTEWATER TX PLNT-MAINTEI 3 <br /> Site address 3900 HOLLY DR 3900 HOLLY DR 103 <br /> City TRACY TRACY 104 <br /> ZIP code 953041618 95304-1618 105 <br /> Facility phone 209-831-4480 (209) 831-4480 102 <br /> Facility mailing address 3900 HOLLY DR Tracy WWTP, 3900 HOLLY DRIVE 108a <br /> TRACY, CA 953041618 TRACY, CA 95304-1618 108b,108c, 108d <br /> BILLING INFORMATION <br /> Contact name TRACY WASTEWATER TX PLNT-MAINTEI CITY OF TRACY WWTP 140 <br /> Address 3900 HOLLY DR 3900 HOLLY DRIVE 143 <br /> TRACY, CA 953041618 TRACY, CA 95304-1618 144, 145, 146 <br /> Contact phone 209-831-4482 (209) 831-4489 141 <br /> Contact email dale.klever@ci.tracy.ca.us 142 <br /> Mail invoices to Facility <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: lA v Date: <br /> -------------------------------------------------- <br /> Accounting: Reviewed by: Date: gl13 1 I6' Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ]-�lled [,] Surcharge 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 /> 1921 -HMSP-Regular-Primary Location PRO519885 MICHAEL PARISSI Active [ ] [ ] <br /> 1963-CalARP PROGRAM 3 FACILITY PR0530005 RAYMOND VON FLUE Active [ ] [ ] <br /> 1995-CaIARP FAC STATE SURCHARGE FEE PRO518944 HAZ MAT SJC OES Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0514044 THUY TRAN Active [ ] [ ] <br /> 2831 -AST FAC >/=1,320-<10 K GAL CUMULATIVE PR0528293 THUY TRAN Active [ ] [ ] <br /> 2217-APPLIANCE RECYCLER PR0521520 ARIS VELOSO Inactive [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PR0232330 STEVE SASSON Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0507494 STEVE SASSON Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0532568 not assigned Inactive [ ] [ ] <br />