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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 5/14/2015 <br /> Submitted on: 5/11/2015 7:54:28AM CERS ID: 10614241 <br /> Submitted by: juan calderon Email: juan.calderon@broncowine.com Facility ID in CERS: FA0019492 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0014607 <br /> Owner name WEST COAST GRAPE FARMING ING WEST COAST GRAPE FARMING INC 111 <br /> Mailing address P.O. BOX 488 P.O. BOX 488 113 <br /> CERES, CA 95307 CERES, CA 95307 114, 115, 116 <br /> Work phone 209-272-3000 209-272-3000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019492 D G <br /> Facility name WEST COAST GRAPE FARMING Avena Ranch 3 <br /> Site address 18293 E AVENA RD 18923 Avena Rd } titi reS-61 0 103 <br /> City ESCALON Escalon C6,r -� 104 <br /> ZIP code 953209542 95320 105 <br /> Facility phone 209-608-2407 209-272-3000 � 102 <br /> Facility mailing address PO BOX 488 P.O. BOX 488 108a <br /> CERES, CA 95307 CERES, CA 95307 108b, 108c,1080 <br /> BILLING INFORMATION - - —. <br /> Contact name WEST COAST GRAPE FARMING FRANK CANELA 140 <br /> Address PO BOX 488 P.O. BOX 488 143 <br /> CERES, CA 95307 CERES, CA 95307 144, 145, 146 <br /> Contact phone Not Specified 209-272-3035 141 <br /> Contact email frank.canela@broncowine.com 142 <br /> Mail invoices to Facility <br /> Program record .,] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: _ Ills <br /> Assigned to: l4aze d <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: Date: 5�2°�/S Clerical: [ ] File [ ] Relabel file ( ] Create new file <br /> [ ] Acct billed [-4-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 /> 2220-SM HW GEN<5 TONS/YR PRO529245 ELENA MANZO Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PRO529244 ELENA MANZO Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO534736 not assigned Inactive <br />