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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 4/2/2015 <br /> Submitted on: 2/26/2015 5:18:17PM CERS ID: 10186723 <br /> Submitted by: Richard Lowry Email: ral@lowryoil.com Facility ID in CERS: FA0017952 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0014748 <br /> Owner name PACIFIC SOUTHWEST IRRIGATION C Jim Clare 111 <br /> Mailing address 8372 S JACK TONE RD 8372 S JACK TONE RD 113 <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 114, 115, 116 <br /> Work phone 209-460-0450 (209)460-0450 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017952 <br /> Facility name PACIFIC SOUTHWEST IRRIGATION CORF PACIFIC SOUTHWEST IRRIGATION CORF 3 <br /> Site address 8372 S JACK TONE RD 8372 S JACK TONE RD 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95215 95215 105 <br /> Facility phone 209-460-0450 (209)460-0450 102 <br /> Facility mailing address 8372 S JACK TONE RD 8372 S JACK TONE RD 108a <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 108b, 108c,1084 <br /> BILLING INFORMATION <br /> Contact name PACIFIC SOUTHWEST IRRIGATION CORE PACIFIC SOUTHWEST IRRIGATION CORF 140 <br /> Address 8372 S JACK TONE RD 8372 S JACK TONE RD 143 <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 144, 145, 146 <br /> Contact phone Not Specified (209)460-0450 141 <br /> Contact email142 <br /> Mail invoices to 10� <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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 calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: �Sr-� Date: Z ]� <br /> --- - — —/--- - ---- -- -- - - - - --- -- - - - <br /> Accounting: Reviewed by: I�GL, Date: s/ 1 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge 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 /> 1921 -HMBP-Regular-Primary Location PRO526511 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0539709 ELENA MANZO Active [ ] [ ] <br /> 2831 -AST FAC >/= 1,320-<10 K GAL CUMULATIVE PRO539738 ELENA MANZO Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531757 not assigned Inactive [ ] [ ] <br />