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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/21/2014 <br /> Submitted on: 1115/2013 10:00:51AM CERS ID: 10181275 <br /> Submitted by: Elmo Bacchini Email: ebacchini164@gmail.com Facility ID in CERS: FA0003664 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0002734 <br /> Owner name BACCHINI, DELSIE E BACCHINI, DELSIE E 111 <br /> Mailing address 16446 E COPPEROPOLIS RD 16446 E COPPEROPOLIS RD 113 <br /> LINDEN, CA 95236 LINDEN, CA 95236 114, 115, 116 <br /> Work phone 2099488010 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003664 <br /> Facility name BACCHINI, DELSIE E BACCHINI, DELSIE E 3 <br /> Site address 16446 E COPPEROPOLIS RD 16446 E COPPEROPOLIS RD 103 <br /> City LINDEN LINDEN 104 <br /> Zip code 95236 95236 105 <br /> Facility phone 209-948-8010 (209) 948-8010 0 102 <br /> Facility mailing address 16446 E COPPEROPOLIS RD 16446 E COPPEROPOLIS RD 108a <br /> LINDEN, CA 95236 LINDEN, CA 95236 1085,108 ,108d <br /> BILLING INFORMATION <br /> Contact name BACCHINI„ DELSIE E BACCHINI, DELSIE E 140 <br /> Address 16446 E COPPEROPOLIS RD 16446 E COPPEROPOLIS RD 143 <br /> LINDEN, CA 95236 LINDEN, CA 95236 144, 145, 146 <br /> Contact phone Not Specified 2099488010 141 <br /> Contact email 142 <br /> Mail invoices to Facility <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: <br /> Accounting: Reviewed by: '] Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> ] Acc ed [ ] Surchar verified ____ 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 PR0525873 not assigned Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0529703 JEFFREY WONG Active I ] [ ] <br /> 2333-FARM UST#1 FACILITY-obsolete PR0234160 LETITIA BRIGGS Inactive I I [ ] <br /> 2830-AST FAC -SPCC EXEMPT PRO529702 JEFFREY WONG Active, Exempt [ ] [ ] <br />