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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/3/2018 <br /> Submitted on: 8/31/2017 1:50:04PM CERS ID: 10181995 <br /> Submitted by: cart navarra Email: canavarra@Caldsl.net Facility ID in CERS: FA0006024 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 3 <br /> Owner ID OW0003306 <br /> Owner name CARMELO PROPERTIES LLC C & A Navarra Ranch, Inc. 1 11 <br /> Mailing address 475 W BLEWETT RD 475 W BLEWETT RD 113 <br /> TRACY, CA 95304 TRACY, CA 95304 114, 115, 116 <br /> Work phone 209-836-0005 112 <br /> FACILITY FILE INFORMATION <br /> Facility lD FA0006024 <br /> Facility name C &A NAVARRA RANCH INC C & A NAVARRA RANCH INC 3 <br /> Site address 475 W BLEWETT RD 475 W BLEWETT RD 103 <br /> City TRACY TRACY 104 <br /> ZIP code 95304 95304 105 <br /> Facility phone 209-836-0005 (209) 836-0005 102 <br /> Facility mailing address 475 W BLEWETT RD 475 W BLEWETT RD 108a <br /> TRACY, CA 95304 TRACY, CA 95304 108b, 10ac,1084 <br /> BILLING INFORMATION <br /> Contact name C & A NAVARRA RANCH INC C & A NAVARRA RANCH INC 140 <br /> Address 475 W BLEWETT RD 475 W BLEWETT RD 143 <br /> TRACY, CA 95304 TRACY, CA 95304 144, 145, 146 <br /> Contact phone Not Specified 209-836-0005 141 <br /> Contact email 142 <br /> Mail invoices to Owner <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP T ] 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: I�'�" _ Date: ] �� <br /> Accounting: Reviewed by: Date: I f 51 ! Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING; THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1958-HM-Farm Operations 1 chem units PRO52583B MUNIAPPA NAIDU Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO529287 f TWO VACANT2 Active [ ] [ ] <br /> 2333-EXCLUDED FARM TANK PR0503934 STEVE SASSON Inactive [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0529286 TWO VACANT2 Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531557 not assigned Inactive [ ] [ ] <br /> C ko'le- 4"A ck, W ��1161A� <br />