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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 2/23/2015 <br /> Submitted on: 1/15/2015 4:48:58PM CERS ID: 10183155 <br /> Submitted by: Karen Sittner Email: ka ren@ precision mach ines.biz Facility ID in CERS: FA0010043 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008043 <br /> Owner name SITTNER, KEVIN Kevin L. Sittner 111 <br /> Mailing address 18805 Benedict Drive 18805 Benedict Drive 113 <br /> Woodbridge, CA 95258 Woodbrige, CA 95258 114, 115, 116 <br /> Work phone 209-369-2600 209369-2600 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010043 <br /> Facility name PRECISION MACHINE & MAINT PRECISION MACHINE & MAINT 3 <br /> Site address 903 BLACK DIAMOND WAY 903 BLACK DIAMOND WAY#A 103 <br /> City LODI LODI 104 <br /> ZIP code 95240-0720 95240-0720 105 <br /> Facility phone 209-369-2600 2093692600 102 <br /> Facility mailing address 903 BLACK DIAMOND WAY#A 903 BLACK DIAMOND WAY#A 108a <br /> LODI, CA 95240 LODI, CA 95240-0720 108b, 108c, 1084 <br /> BILLING INFORMATION <br /> Contact name Terri Sittner Terri Sittner 140 <br /> Address 903 BLACK DIAMOND WAY#A 903 BLACK DIAMOND WAY#A 143 <br /> LODI, CA 95240 LODI, CA 95240-0720 144, 145. 146 <br /> Contact phone 209-369-2600 2093692600 141 <br /> Contact email <br /> 142 <br /> Mai'f invoices to <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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: 2� Date: 3 h b K — 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 PR0520040 JAMIE DE LA ROSA Active [ ] [ <br /> 2220-SM HW GEN<5 TONS/YR PR0514142 ARIS VELOSO Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510043 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534005 not assigned Inactive [ ] [ ] <br />