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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11/22/2016 <br /> Submitted on: 11/17/2016 7:13:26AM CERS ID: 10183011 <br /> Submitted by: Kyle Nelson Email: knelson@kempersports.com Facility ID in CERS: FA0009902 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 10 <br /> Owner ID OW0007847 <br /> Owner name City of Stockton CITY OF STOCKTON -PARKS & REC 111 <br /> Mailing address 1465 S Lincoln St 6 E LINDSAY ST 113 <br /> Stockton, CA 95206 STOCKTON, CA 95202-1997 114, 115, 116 <br /> Work phone 209-937-8341 209-937-8206 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0009902 <br /> Facility name STKN SWENSON GOLF COURSE STKN SWENSON GOLF COURSE 3 <br /> Site address 6803 ALEXANDRIA PL 6803 ALEXANDRIA PL 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95207 95207 105 <br /> Facility phone 209-937-7361 (209) 937-7361 0 102 <br /> Facility mailing address 6 E LINDSAY ST 6 E LINDSAY ST 108a <br /> STOCKTON, CA 95202-1997 STOCKTON, CA 95202-1997 108b. 10ac,1084 <br /> BILLING INFORMATION <br /> Contact name STKN SWENSON GOLF COURSE STKN SWENSON GOLF COURSE 140 <br /> Address 6 E LINDSAY ST 6 E LINDSAY ST 143 <br /> STOCKTON, CA 95202- 19 STOCKTON, CA 95202- 19 144, 145, 146 <br /> Contact phone 209-937-7361 209-937-7361 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 thialendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: rr 1 (t Date: iI�ZZ�iC <br /> Accounting: Reviewed by: � Date:]I (30�(L Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] 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 -HMBP-Regular-Primary Location PRO519946 HAZA SAEED Active [ ] [ ] <br /> 2220-SM HW GEN c5 TONSNR PRO539043 VICKI MCCARTNEY Active [ ] [ ] <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PRO512190 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2226-CaIARP PROGRAM PRO514696 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO509902 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532235 not assigned Inactive [ ] [ ] <br />