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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 11/6/2014 <br /> Submitted on: 10/14/2014 2:21:22PM CERS ID: 10184489 <br /> Submitted by: eric koster Email: eric@jhmarine.com Facility ID in CERS: FA0013653 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0010763 <br /> Owner name KOSTER, ERIC KOSTER, ERIC 111 <br /> Mailing address 2040 SAN ESTEBAN CIR 401 N SAN JOSE ST 113 <br /> ROSEVILLE, CA 95747 STOCKTON, CA 95203-2631 114, 115, 116 <br /> Work phone 209-951-0283 2099922958 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0013653 <br /> Facility name J & H MARINE J & H MARINE 3 <br /> Site address 401 N SAN JOSE ST 401 N SAN JOSE ST 103 <br /> City STOCKTON STOCKTON 104 <br /> Zip code 95203-2631 95203-2631 105 <br /> Facility phone 209-951-0283 (209) 951-0283 102 <br /> Facility mailing address 401 N SAN JOSE ST 401 N SAN JOSE ST 108a <br /> STOCKTON, CA 95203-2631 STOCKTON, CA 95203-2631 108b, 108c, 108d <br /> BILLING INFORMATION <br /> Contact name J & H MARINE — Cindy Luque 140 <br /> Address 401 N SAN JOSE ST 401 N SAN JOSE ST 143 <br /> STOCKTON, CA 95203-2631 STOCKTON, CA 95203-2631 144, 145, 146 <br /> Contact phone 209-951-0283 2099510283 141 <br /> Contact email cynthia@jhmarine.com 142 <br /> Mail invoices to Fa?illity PC <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 <br /> calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: VA Date: tt- b'k� <br /> Accounting: Reviewed by: Date: Clerical: File [ ] Relabel file [ ] Create new file <br /> ---- ---- <br /> N V <br /> -- [ ] <br /> mc —ed— [ ] Surchar— erifie By: Date: <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 PRO518012 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONSNR PRO518011 JEFFREY WONG Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO518013 HAZ MAT SJC DES Inactive <br />