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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS integration Wizard <br /> Date run: 6/2112014 <br /> Submitted on: 2/7/2014 3:09:33PM CERS IID: 10181835 <br /> Submitted by:ferry loogman Email: loogmanranch a@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, tib <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,iaac, 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 Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG 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: Date: <br /> Accounting: Reviewed by: — Dater Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] A illed [ ] Surcha v rified 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 PRO525899 not assigned Active [ ] [ ] <br /> 2332-EXEMPT TANK FACILITY PR0502482 ELENA MANZO Active, Exempt [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0507591 MUNIAPPA NAIDU Inactive [ ] [ J <br /> 2840-AST EXEMPT FAC < 1.320 GAL PR0529988 WILLY NG Active, Exempt [ j [ <br />