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SAN JOACIUIiv.-OUNTY ENVIRONMENTAL HEALTH-ttE"PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Dat=7/�212014 <br /> CERS 1D: 10187353 <br /> Submitted on: 211012014 4:47:13PM Facility ID in CERS: FA0019714 <br /> Submitted by: Warren Bogle Email: warren@boglewinery.com <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0016171 Warren Bogle 111 <br /> Owner name B2 VINEYARD 49762 HAMILTON RD 113 <br /> Mailing address 49762 HAMILTON RD CLARKSBURG, CA 95612 114, 115, lis <br /> CLARKSBURG, CA 95612 (916)744-1669 112 <br /> Work phone <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0019714 B2 VINEYARD 3 <br /> Facility name B2 VINEYARD 17951 E. Liberty Rd. 103 <br /> Site address 0 N LIBERTY RD Galt 104 <br /> City CLEMENTS 95632 105 <br /> Zip code 95227 916 744-1669 102 <br /> Facility phone 916-744-1669 ( ) <br /> 49762 HAMILTON RD 108a <br /> Facility mailing address 49762 HAMILTON RD <br /> CLARKSBURG, CA 95612 <br /> CLARKSBURG, CA 95612 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name B2 VINEYARD 49 HAMILTON 143 <br /> VINEYARD 140 <br /> Address 49762 HAMILTON RD C9 <br /> LAR <br /> CLARKSBURG, CA 95612 CLARKSBURG, CA 95612 1aa, las, 1a6 <br /> Contact phone Not Specified warren@boglewinery.com <br /> 141 <br /> Contact email warren@baglewinery.com 142 <br /> Mail invoices to Owner <br /> Program record [ } HMBP [ ] SQG HW [ ] LOG 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: Pj Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surchar I led 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 PR0529877 not assigned Active [ 1 [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE 1- PR0534206 not assigned Inactive [ ] [ ] <br />