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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 4/6/2017 <br />Submitted on: 3/9/2017 2:34:29PM CERS ID: 10418008 <br />Submitted by: Terry Paoletti Email: tsquareyp@aol.com Facility ID in CERS: FA0022190 <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner: 2 <br />OW0018468 <br />Richard,Jim & Sam Tanaka <br />8421 Terrace Drive <br />Stockton, CA 95212 <br />209-931-2202 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0022190 <br />Facility name <br />Tanaka Farms Burge Road <br />Site address <br />3300 Burge Rd <br />City <br />Stockton <br />ZIP code <br />95215 <br />Facility phone <br />209-931-2202 <br />Facility mailing address 8421 Terrace Drive <br />Stockton, CA 95212 <br />BILLING INFORMATION <br />Contact name <br />Address <br />Contact phone <br />Contact email <br />Mail invoices to <br />Terry Paoletti <br />8421 Terrace Drive <br />Stockton, CA 95212 <br />tsquareyp@aol.com <br />Account <br />Information after CIW processing CERS <br />(current submittal) field <br />*Jim & Sam Tanaka 111 <br />8421 Terrace Drive 113 <br />Stockton, CA 95212 114, 115, 116 <br />209-931-2202 112 <br />Tanaka Farms Burge Road 3 <br />3300 Burge Rd 103 <br />Stockton 104 <br />95215 105 <br />209-931-2202 102 <br />8421 Terrace Drive 108a <br />Stockton, CA 95212 108b, 108c, 108d <br />Terry Paoletti <br />140 <br />8421 Terrace Drive <br />143 <br />Stockton, CA 95212 <br />144, 145, 146 <br />tsquareyp@aol.com <br />141 <br />tsquareyp@aol.com <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />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: 00--4_ Date: ('( —6-17 <br />Accounting: Reviewed by: � Date: �� J 7 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />----------------------------------------------- <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactivated Inactivated <br />1958 - HM -Farm Operations 0 chem units PR0538643 MUNIAPPA NAIDU Active, Exempt I I I <br />