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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 2/9/2015 <br /> Submitted on: 1/13/2015 10:29:35AM <br /> Submitted by: kurt sharp Email: kurtrazorsharp@gmaii.com ID: 10181941 <br /> p@gmail.com Facility ID in CERS: FA0005806 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0002262 <br /> Owner name SILVA, CONRAD SILVA, CONRAD <br /> Mailing address 1431 W WALNUT ST 1431 W WALNUT ST 111 <br /> STOCKTON, CA 95203113 <br /> STOCKTON, CA 95203 114, 115, 116 <br /> Work phone 2094651834 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0005806 <br /> Facility name CONRAD SILVA FARMS 39-92 CONRAD SILVA FARMS 39-92 3 <br /> Site address 3211 S HOLT RD 3211 S HOLT RD <br /> City STOCKTON STOCKTON 103 <br /> 0 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209-483-8774 2094651834 102 <br /> Facility mailing address 1431 W WALNUT ST 1431 W WALNUT ST 108a <br /> STOCKTON, CA 95203 STOCKTON, CA 95203 108b, 108c load <br /> BILLING INFORMATION <br /> Contact name CONRAD SILVA FARMS 39-92 CONRAD SILVA FARMS 39-92 140 <br /> Address 1431 W WALNUT ST `,i' 1431 W WALNUT ST 143 <br /> STOCKTON, CA 95203 STOCKTON, CA 95203 144, 145 146 <br /> Contact phone 209-483-8774 2096039330 141 <br /> Contact email Ikurtrazorsharp@gmail.com 142 <br /> Mail invoices to r 1 4- <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: [ j full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: ' Jv"r Date: <br /> Accounting: Reviewed by: � Date: 3 '� j Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified B <br /> --m _- _- --- - — y Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and DescriiDtion Record ID Employee name Status Reactivated Inactivated <br /> 1958-HM-Farm Operations PR0525817 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HVV GEN <5 TONS/YR PRO530938 STACY RIVERA Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0530936 STACY RIVERA Active [ ] [ ] <br /> 2765-EMPLOYEE HOUSING-PERMANENT>180 DAYS PR0503370 LISA MEDINA Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE Fd PR0532445 not assigned Inactive [ ] [ ] <br />