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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; 211 /2014 4:55:46PM CERS ID: 10181T65 <br /> Submitted by: Bruce Fry Email: brucefry@mohrfry.com <br /> Facility ID in CERS; FA0005190 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0004058 <br /> Owner name FRY& SON LLC Bruce Fry 111 <br /> Mailing address 12609 N WEST LN 22000 N. Lower Sacramento Road 113 <br /> LODI, CA 95240 Acampo, CA 95240 114, 115, 116 <br /> Work phone 209-334-3808 2093343808 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0005190 <br /> Facility name FRY& SON LLC RANCH 70 3 <br /> Site address 2720 E ACAMPO RD 2720 E ACAMPO RD 103 <br /> City ACAMPO ACAMPO 104 <br /> Zip code 95220 95220 105 <br /> Facility phone 209-334-3808 (209) 334-3808 102 <br /> Facility mailing address 12609 N WEST LN 12609 N WEST LN 108a <br /> LODI, CA 95240 LODI, CA 95240 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name FRY& SON LLC FRY&SON LLC 140 <br /> Address 12609 N WEST LN 12609 N WEST LANE 143 <br /> LODI, CA 95240 LODI, CA 95240 144, 145, 146 <br /> Contact phone Not Specified 2093343808 141 <br /> Contact email 142 <br /> Mail invoices to — - / <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA f ] CaIARP [ ] LIST 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: 1 Date: ! <br /> Accounting: Reviewed by: Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] <br /> Aqpt6illed [ ] Surch verifie : <br /> y to B Date: <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-Farm Operations PR0525938 not assigned Active [ ] [ ] <br /> 2333-FARM UST#1 FACILITY-obsolete PRO501694 Fatina Zareef Inactive [ ] [ <br />