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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6!27/2014 <br /> Submitted on: 5/30/2013 10:17:28AM 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 /> 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 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,1o8c,load <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 CA 95220 144, 145, 146 <br /> Contact phone 209-368-0287 209Zeaiol.com <br /> 31 141 <br /> Contact email rrjse142 <br /> Mail invoices to Facility J <br /> Program record [ ] HMBP [ j SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ j full calendar year [ ] prorate this calendar year [ ] next calendarear <br /> [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: �� Date: (9 2 U[� y <br /> -- —— —— — — - -- -- — -- --- — — 8 — - -- - - - -- <br /> Accounting: Reviewed by: Date: Clerical: � File [ ] Relabel file [ ] Create new file <br /> [ ] Ac led [ ] Surcha verified <br /> --- - — y: 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 PRO525769 not assigned Active [ ] [ ] <br /> 2011 -GRADE A DAIRY PR0200121 KADEANNE LINHARES Active [ ] [ ] <br /> 2221 -USED OIL ONLY-<5 TONS/YR PRO538458 ARIS VELOSO Active [ ] [ ] <br /> 2333-FARM UST#1 FACILITY-obsolete PR0503109 Fatina Zareef Inactive [ ] [ ] <br /> 2775-EMPLOYEE HOUSING-DAIRY EXEMPTION PR0516801 ROBIN TRINDADE Inactive [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0529326 ARIS VELOSO Active, Exempt [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0523681 TED TASIOPOULOS Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531344 not assigned Inactive [ ] [ ] <br />