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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 4/6/2015 <br /> Submitted on: 2/3/2015 7:28:55AM CERS ID: 10183317 <br /> Submitted by: Lisa Acevedo Email: lisa.acevedo@faa.gov Facility ID in CERS: FA0010208 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008208 <br /> Owner name FEDERAL AVIATION ADMIN FEDERAL AVIATION ADM IN 111 <br /> Mailing address 11025 TRADE CENTER DR 7434 S Lindbergh St 113 <br /> RANCHO CORDOVA, CA 95670 Stockton, CA 95206 114, 115,116 <br /> Work phone 208-946-6310 209-234-1090 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010208 <br /> Facility name FEDERAL AVIATION ADMIN FEDERAL AVIATION ADMIN 3 <br /> Site address 7434 S LINDBERGH ST 7434 S LINDBERGH ST 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209-234-1090 (209) 234-1090 102 <br /> Facility mailing address 7434 S Lindbergh Street 7434 S Lindbergh Street 108a <br /> Stockton, CA 95206 Stockton, CA 95206 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name FEDERAL AVIATION ADMIN James Tincup 140 <br /> Address 7434 S Lindbergh Street 7434 S Lindbergh Street 143 <br /> Stockton, CA 95206 Stockton, CA 95206 144, 145, 146 <br /> Contact phone 209-234-1090 209-234-1090 141 <br /> Contact email james.tincup@faa.gov james.tincup@faa.gov 142 <br /> Mail invoices to Account ,/ <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA <br /> [ ] CaIARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next Calendarear <br /> y [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: P +7 Date: <br /> ----------------------- <br /> 9 y / y �� [ ] Relabel file—[—] Create new file <br /> Accountin Reviewed b : Date: s 1 Clerical: [ ] File <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ----— --- <br /> — ---- - ——- <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 PR0520214 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PRO539089 STACY RIVERA Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510208 HAZ MAT SJC OES Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533827 not assigned Inactive [ J [ ] <br />