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E:: SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11f2512014 <br /> Submitted on: 11/21/2014 2:23:30PM <br /> Submitted by. Mike Grape Email: mikegrape@aol.com CERS (©' 10185539 <br /> Facility ID in CERS: 1=A0016868 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0013709 <br /> Owner name BALLATORE FARMS BALLATORE FARMS <br /> Mailing address 20366 S CARROLTON RD111 <br /> 20336 S 'CARROLTON RD 113 <br /> RIPON, CA 95366 RIPON, CA 95366 114, 115, 11E <br /> Work phone (209) 599-3002 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016868 <br /> Facility name BALLATORE FARMS BALLATORE FARMS 3 <br /> Site address 20336 S CARROLTON RD 20336 S CARROLTON RD 103 <br /> City RIPON RIPON 104 <br /> ZIP code 95366 95366 105 <br /> Facility phone 209-599-3002 (209) 599-3002 102 <br /> Facility mailing address 20366 S CARROLTON RD 20336 S CARROLTON RD 108a <br /> RIPON, CA 95366 RIPON, CA 95366 108b, 108c,10E <br /> BILLING INFORMATION <br /> Contact name BALLATORE FARMS BALLATORE FARMS 140 <br /> Address 20336 S CARROLTON RD 20336 S CARROLTON RD 143 <br /> RIPON, CA 95366 RIPON, CA 95366 144, 145, 14f <br /> Contact phone Not Specified (209) 599-3002 141 <br /> Contact email mikegrape@aol.com 142 <br /> Mail invoices to GqiRw - <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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: IT5_1 I L <br /> Accounting: Reviewed by: Date: Clerical: [ ) File [ ] Relabel file [ ] Create new file <br /> [ ] Acc ed j ] Surch veri ied 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 PR0525053 not assigned Active [ ] [ <br /> 2840-AST EXEMPT FAC < 1,320 GAL PR0529314 WILLY NG Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531573 not assigned Inactive [ ] [ ] <br />