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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11/2512014 <br /> Submitted on: 11/23/2014 9:26:23AM CERS ID: 10185501 <br /> Submitted by: Vic Mettler Email: vmettler@zapline.com Facility ID in CERS: FA0016847 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0013688 <br /> Owner name JERRY D METTLER JERRY D METTLER 111 <br /> Mailing address 16441 N LOCUST TREE RD 16441 N LOCUST TREE RD 113 <br /> LODI, CA 95240 LODI, CA 95240 114, 115, 11E <br /> Work .phone (209) 334-5686 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016847 <br /> Facility name JERRY D METTLER JERRY D METTLER 3 <br /> Site address 16441 N LOCUST TREE RD 16441 N LOCUST TREE RD 103 <br /> City LODI LODI 104 <br /> ZIP code 95240 95240 105 <br /> Facility phone 209-334-5686 (209) 334-5686 102 <br /> Facility mailing address 16441 N LOCUST TREE RD 16441 N LOCUST TREE RD 108a <br /> LODI, CA 95240 LODI, CA 95240 i®se, iasc, IOE <br /> BILLING INFORMATION <br /> Contact name JERRY D METTLER JERRY D METTLER 140 <br /> Address 16441 N LOCUST TREE RD 16441 N LOCUST TREE RD 143 <br /> LODI, CA 95240 LODI, CA 95240 144, 145, 14E <br /> Contact phone Not Specified 209-481-3386 141 <br /> Contact email 142 <br /> Mail invoices to Gwoer , <br /> Program record [ ] HMBP [ ] SQG HW [ ) LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARIP [ ] 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:i 4 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> ] Acc I[ed [ ] Surch ver fieclBy: 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 PRO525032 not assigned Active [ ] [ ] <br /> 2840-AST EXEMPT FAC < 1,320 GAL PRO529486 WILLY NG Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532772 not assigned Inactive [ ] [ ] <br />