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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 5/12/2017 <br /> Submitted on: 5/10/2017 10:23:10AM CERS ID: 10181167 <br /> Submitted by: JOY SEIFERT Email: rrjseifert@aol.com Facility ID in CERS: FA0003459 <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 : 1 <br /> Owner ID OW0002580 <br /> Owner name SEIFERT, ROBERT&JOY ANN SEIFERT, ROBERT&JOY ANN 111 <br /> Mailing address 8505 E COLLIER RD 8505 E COLLIER RD 113 <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 114, 115, 116 <br /> Work phone 209-810-3434 (209) 810-3434 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003459 <br /> Facility name SEIFERT DAIRY LP SEIFERT DAIRY LP 3 <br /> Site address 8505 E COLLIER RD 8505 E COLLIER RD 103 <br /> City ACAMPO ACAMPO 104 <br /> ZIP code 95220 95220 105 <br /> Facility phone 209-334-4314 (209) 334-4314 102 <br /> Facility mailing address 8505 E COLLIER RD 8505 E COLLIER RD 108a <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 108b, 108c,1084 <br /> BILLING INFORMATION <br /> Contact name SEIFERT DAIRY LP SEIFERT DAIRY LP 140 <br /> Address 8505 E COLLIER RD 8505 E COLLIER RD 143 <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 144, 145, 146 <br /> Contact phone 209-334-4314 (209) 334-4314 141 <br /> Contact email rrjseifert@aol.com rrjseifert@aol.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this (calendar year [ ] next calendar year [ ] exempt from billing <br /> 1 <br /> Processed through CERS Integration Wizard by: �No Date: � <br /> Accounting: Reviewed by: _�Date: 7!16-1!7 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 PRO525769 MUNIAPPA NAIDU Active [ ] [ ] <br /> 2011 -GRADE A DAIRY PR0200121 NICHOLAS WIESEMAN Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0529326 AARON HANG Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO523681 TED TASIOPOULOS Active [ ] [ ] <br /> 2221 -USED OIL ONLY-<5 TONS/YR PRO538458 AARON HANG Inactive [ ] [ ] <br /> 2333-EXCLUDED FARM TANK PR0503109 ONE VACANT? Inactive [ ] [ ] <br /> 2775-EMPLOYEE HOUSING-DAIRY EXEMPTION PRO516801 ROBIN TRINDADE Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO531344 not assigned Inactive [ ] [ ] <br />