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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: 2/7/2014 3:09:33PM CERS ID: 10181835 <br /> Submitted by:jerry loogman Email: loogmanranch@clearwire.net Facility ID in CERS: FA0005464 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0004294 <br /> Owner name LOOGMAN, GEORGE LOOGMAN, GEORGE 111 <br /> Mailing address 22202 VAN ALLEN 22202 VAN ALLEN 113 <br /> ESCALON, CA 95320 ESCALON, CA 95320 114, 115, 116 <br /> Work phone 209-838-3461 (209) 838-3461 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0005464 <br /> Facility name LOOGMAN, GEORGE LOOGMAN, GEORGE 3 <br /> Site address 22202 VAN ALLEN RD 22202 VAN ALLEN RD 103 <br /> City ESCALON ESCALON 104 <br /> Zip code 95320 95320 105 <br /> Facility phone 209-838-3461 (209) 838-3461 102 <br /> Facility mailing address 22202 VAN ALLEN 22202 VAN ALLEN 108a <br /> ESCALON, CA 95320 ESCALON, CA 95320 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name LOOGMAN, GEORGE LOOGMAN, GEORGE 140 <br /> Address 22202 VAN ALLEN 22202 VAN ALLEN 143 <br /> ESCALON, CA 95320 ESCALON, CA 95320 144, 145, 146 <br /> Contact phone 209-838-3461 (209) 838-3461 141 <br /> Contact email 142 <br /> Mail invoices to Facilityw" <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: (21)Y-' Date: 2 <br /> Accounting: Reviewed by: Date Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> __ [ ] Ac filled [ ] Surcha v rifled __________By:_____ Date____ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1958-HM-Farm Operations PR0525899 not assigned Active [ ] [ ] <br /> 2332-EXEMPT TANK FACILITY PR0502482 ELENAMANZO Active, Exempt [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO507591 MUNIAPPA NAIDU Inactive [ ] [ ] <br /> 2840-AST EXEMPT FAC <1,320 GAL PR0529988 WILLY NG Active, Exempt [ ] [ ] <br />