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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11/14/2014 <br /> Submitted on: 11/11/2014 2:45:10PM CERS ID: 10461103 <br /> Submitted by: Steve Barsoom Email: barsoom@citlink.net Facility ID in CERS: FA0000151 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000128 <br /> Owner name Ensher, Alexander Barsoom, Inc. Ensher, Alexander Barsoom, Inc. 111 <br /> Mailing address PO Box 1044 PO Box 1044 113 <br /> Walnut Grove, CA 95690 Walnut Grove, CA 95690 114, 115,116 <br /> Work phone 916-417-8205 (916)417-8205 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000151 <br /> Facility name Stockton Ranch Stockton Ranch 3 <br /> Site address 14125 HWY 4 14125 California 4 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 916-417-8205 (916)417-8205 102 <br /> Facility mailing address PO Box 1044 PO Box 1044 108a <br /> Walnut Grove, CA 95690 Walnut Grove, CA 95690 108b,108c,10ad <br /> BILLING INFORMATION <br /> Contact name Jim Barsoom Jim Barsoom 140 <br /> Address PO Box 1044 PO Box 1044 143 <br /> Walnut Grove, CA 95690 Walnut Grove, CA 95690 144, 145, 146 <br /> Contact phone 916-417-8205 (916)417-8205 141 <br /> Contact email 142 <br /> Mail invoices to Fa3 #^- <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 calendarear <br /> U y [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: �—Date: (1. N-L / <br /> -------------------------------------------------- <br /> Accounting: Reviewed by: W Date: I J17W Clerical: [q File [ ] Relabel file [ ] Create new file <br /> [ ] If r <br /> [ ] Surchar (fled B : Date: <br /> —— A Illed <br /> ------------------------- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1958-HM-Faun Operations PR0538329 not assigned Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO538328 STACY RIVERA Active [ ] [ ] <br /> 2831-AST FAC >/=1,320-<10 K GAL CUMULATIVE PRO538330 STACY RIVERA Active [ ] [ ] <br /> 2755-EMPLOYEE HOUSING-SEASONAL<180 DAYS PR0270095 OMRAN SOOD Inactive [ ] [ ] <br />