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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1112612014 <br /> Submitted on: 11/22/2014 10:46:50AM CERS ID: 10186441 <br /> Submitted by: Te Velde Te Velde Email: geotevelde@gmail.com Facility ID in CERS: FA0017430 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0014271 <br /> Owner name THE OAKS RANCH THE OAKS RANCH 111 <br /> Mailing address 3301 LADD RD 3301 LADD RD 113 <br /> MODESTO, CA 95356 MODESTO, CA 95356 114, 115, 11E <br /> Work phone 209-545-1708 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017430 <br /> Facility name THE OAKS RANCH THE OAKS RANCH 3 <br /> Site address 0 DODDS & STINEGEL(BACK) 0 DODDS & STINEGEL (BACK) 103 <br /> City FARMINGTON FARMINGTON 104 <br /> ZIP code 95230 95230 105 <br /> Facility phone 209-545-1708 (209) 545-1708 0 102 <br /> Facility mailing address 3301 LADD RD 3301 LADD RD 108a <br /> MODESTO, CA 95356 MODESTO, CA 95356 108b, iosc,roe <br /> BILLING INFORMATION <br /> Contact name OAKS RANCH OAKS RANCH 140 <br /> Address 3301 LADD RD 3301 LADD RD 143 <br /> MODESTO, CA 95356 MODESTO, CA 95356 144, 145, 14€ <br /> Contact phone Not Specified 209-545-1708 141 <br /> Contact email 142 <br /> Mail invoices to 04vrw <br /> Program record [ J HMBP [ ] SOG 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: <br /> \ Clerical: [ ] File [ ] Relabel file [ j Create new file <br /> [ j <br /> Ac,pt AW d [ ] Surchar ertfied l 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-Fara Operations PR0525615 not assigned Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534252 not assigned Inactive [ ) [ ] <br />