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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 4/24/2018 <br /> Submitted on: 12/30/2017 2:37:04PM CERS ID: 10185693 <br /> Submitted by: Wayne Bruns Email: ryan.cwfarms@gmail.com Facility ID in CERS: FA0016966 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 1 <br /> Owner ID OW0013807 <br /> Owner name WAYNE & CAROL BRUNS WAYNE & CAROL BRUNS 111 <br /> Mailing address 18585 Mello Rd 18585 Mello Rd 113 <br /> RIPON, CA 95366 RIPON, CA 95366 114, 115, 116 <br /> Work phone 209456-6249 209-456-6249 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016966 <br /> Facility name WAYNE & CAROL BRUNS WAYNE &CAROL BRUNS 3 <br /> Site address 18585 E MELLO AVE 18585 E MELLO AVE 103 <br /> City RIPON RIPON 104 <br /> ZIP code 95366 95366 105 <br /> Facility phone 209-456-6249 (209) 456-6249 102 <br /> Facility mailing address 18585 Mello Rd 18585 Mello Rd 108a <br /> RIPON, CA 95366 RIPON, CA 95366 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name WAYNE & CAROL BRUNS WAYNE & CAROL BRUNS 140 <br /> Address 18585 Mello Rd 18585 Mello Rd 143 <br /> RIPON, CA 95366 RIPON, CA 95366 144, 145, 146 <br /> Contact phone 209-456-6249 209-456-6249 141 <br /> Contact email 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ SQG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: <br /> Assigned to: F[oj� ) <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: aye t2, Date: 4--�LA—N <br /> -------------------------------------------------- <br /> Accounting: Reviewed by: _14�) Date: 5111181 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ IJ/Acct billed [„]Surcharge verified By: Date: <br /> ------------- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1958-HM-Farm Operations 1 chem units PRO525151 MUNIAPPA NAIDU Active [ ] [ ] <br /> 2840-AST EXEMPT FAC <1,320 GAL PRO529944 WILLY NG Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533800 not assigned Inactive [ ] [ ] <br /> ('rec�kc& -�Lo cxc, per <br /> �tMl �jD-7 g� <br />