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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/2/2014 <br /> Submitted on: 11/25/2014 1:37:11PM CERS ID: 10183125 <br /> Submitted by: Stanley Seifert Email seifert@softcom.net Facility ]Din 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 address 9450 E COLLIER RD 9450 E COLLIER RD 113 <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 114, 115, 11f <br /> Work phone 209-367-0850 209-367-0850 112 <br /> FACILITY FILE INFORMATION <br /> Faciiity 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 /> Cihv ACAMPO ACAMPO 104 <br /> ZIP code 95220 95220 105 <br /> Facility phone 209-3670850 (209) 367-0850 102 <br /> Facility mailing address 9450 E COLLIER RD 9450 E COLLIER RD 108a <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 108b,148c,1QE <br /> BILLING INFORMATION <br /> Contact naii,c- 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, 14E <br /> Contact phone Not Specified 209-367-0850 141 <br /> Contac, '- " ' <br /> 142 <br /> Mail invoices to E.ae++i4q � <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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 CEi: <br />