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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12J1612014 <br /> Submitted on: 12/4/2014 11:39:16AM CERS ID: 10181285 <br /> Submitted by: Claudia Machado Email: cldmchd@aol.com Facility ID in CERS: FA0003671 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0002741 <br /> Owner name MACHADO, ANTHONY G & FRANK F Machado, Joe 111 <br /> Mailing address 12700 E LOUISE AVE 11500 E FRENCH CAMP RD 113 <br /> MANTECA, CA 95336 MANTECA, CA 95336 114, 115, 11E <br /> Work phone 209-823-6785 209-483-9865 112 <br /> FACILITY FILE INFORMATION <br /> Facility I D FA0003671 <br /> Facility name MACHADO BROS DAIRY JM Dairy 3 <br /> Site address 12700 E LOUISE AVE 12700 E LOUISE AVE 103 <br /> City MANTECA 104 <br /> ZIP code 95336 95336 105 <br /> Facility phone 209-823-6785 (209) 982-1722 102 <br /> Facility mailing address 12700 E LOUISE AVE MANTECA 11500 E French Camp Road 108a <br /> MANTECA, CA 95336 MANTECA, CA 95336 108b, 108c,108 <br /> BILLING INFORMATION <br /> Contact name MACHADO BROS DAIRY Machado, Joe 140 <br /> Address 12700 E LOUISE AVE 11500 E FRENCH CAMP RD 143 <br /> MANTECA, CA 95336 MANTECA, CA 95336 144, 145, 14f <br /> Contact phone Not Specified 209-483-9865 141 <br /> Contact email cldmchd@aol.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: C" 5(1L i I <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: )I ZZ i <br /> Assigned to: l_�-5 <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: All, Date: 17 11& 11-1 <br /> Accounting: Reviewed by: IL-Y Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> Surchar rifi d _ By: Date_ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 2830-AST FAC -SPCC EXEMPT PR0530339 ELENA MANZO Active <br /> 2332-EXEMPT TANK FACILITY PR0234016 ALISON YOUNGBLOOD Active, Exempt [ ) [ ] <br /> 1958-HM-Farm Operations PRO525779 MICHAEL PARISSI Inactive [ ] [ ] <br /> 2011 -GRADE A DAIRY PR0200022 NICHOLAS WIESEMAN Inactive [ ] [ ) <br /> 2301 -UST STATE SURCHARGE FEE PR0508288 ALISON YOUNGBLOOD Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAG STATE SURCHARGE FEE PR0507389 ALISON YOUNGBLOOD Inactive [ ] [ ] <br /> 2775-EMPLOYEE HOUSING-DAIRY EXEMPTION PR0515587 ROCHELLE VELOSO Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0532186 not assigned Inactive [ ] [ ] <br />