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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/21/2014 <br /> Submitted on: 1124f2014 11:29:44AM CERS ID: 10181463 <br /> Submitted by: Chris Phelps Email: vwmarina@sbcglobal.net sbcglobal.net <br /> Facility ID in CERS: FA0003830 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0002836 <br /> Owner name LINCOLN VILLAGE WEST MARINA LT PEGASUS GROUP 111 <br /> Mailing address 6649 EMBARCADERO DR 6649 EMBARCADERO DR 113 <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 114, 115, 116 <br /> Work phone 925-930-0810 (925)930-0810 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003830 <br /> Facility name VILLAGE WEST MARINA VILLAGE WEST MARINA 3 <br /> Site address 6649 EMBARCADERO DR 6649 EMBARCADERO DR 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95219 95219 105 <br /> Facility phone 209-951-1551 (209) 951-1551 102 <br /> Facility mailing address 6649 EMBARCADERO DR 6649 EMBARCADERO DR 108a <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 108b. 108c, 108d <br /> BILLING INFORMATION <br /> Contact name VILLAGE WEST MARINA VILLAGE WEST MARINA 140 <br /> Address 6649 EMBARCADERO DR 6649 EMBARCADERO DR 143 <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 144, 145, 146 <br /> Contact phone 209-951-1551 (209)951-1551 141 <br /> Contact email 142 <br /> Mail invoices to Owner ' <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: kkAJ Date: <br /> Accounting: Reviewed by: " Date: { Clerical: /// File [ ] Relabel file [ ] Create new file <br /> — [ ] Acc� ed [ ] Surge 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-Common Materials PRO519700 HAZA SAEED s Active [ ] [ ] <br /> 2220-SM HW GEN <5 TONSIYR PRO517849 Fatina Zareef Active [ ] ] ] <br /> 2361 -UST FACILITY PR0231098 Fatina Zareef Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0507487 MICHAEL KITH Inactive [ ] [ ] <br />