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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 12/29/2016 <br /> Submitted on: 12/23/2016 3:17:58PM CERS ID: 10166971 <br /> Submitted by: Denise Holmes Email: Denise.Holmes@fosterfarms.com Facility ID in CERS: FA0017537 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> (current EC database) (current submittal) field <br /> OWNER INFORMATION Number of Facilities for this Owner: 1 <br /> Owner ID OW0014378 111 <br /> Foster Farms LLC <br /> Owner name Foster Farms <br /> Mailing address P.O. Box 831 P.O. Box 831 113 <br /> Livingston, CA 95334 Livingston, CA 95334 114, 115, 116 <br /> Work phone 209-394-7901 2093947901 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017537 3 <br /> Facility name Foster Farms Flood 2 Ranch Foster Farms Flood 2 Ranch <br /> 103 <br /> Site address 24801 E Flood Rd 24801 E Flood Rd <br /> City Linden Linden 104 <br /> ZIP code 95236 95236 105 <br /> Facility phone 209-394-7901 2093947901 102 <br /> Facility mailing address P.O. Box 831 P.O. Box 831 108a <br /> 9 <br /> Livin ston, CA 95334 108b,108c,108d <br /> Livingston, CA 95334 <br /> BILLING INFORMATION 140 <br /> Contact name FOSTER FARMS FLOOD#2 RANCH Denise Holmes 143 <br /> Address P.O. Box 831 P.O. Box 831 <br /> Livingston, CA 95334 Livingston, CA 95334 144, 145, 146 <br /> Contact phone 209-394-5352 2093945352 141 <br /> Contact email shelley.worsham@fosterfarms.com denise.holmes@fosterfarms.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG 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 /> Processed through CERS Integration Wizard by: e4a A4 Date: 1�2 II LP <br /> Accounting: Reviewed by: Date: <br /> f ,� � �3�I'1 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> it.rJ <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 /> PRO525722 MUNIAPPA NAIDU Active <br /> 1958-HM-Farm Operations 1 chem units - <br /> 2840-AST EXEMPT FAC < 1,320 GAL PR0530144 WILLY NG Inactive } ] } <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532515 not assigned Inactive [ } t } <br />