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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to FnvisionConnect by CERS Integration Wizard <br /> Date run: 1/13/2015 <br /> Submitted on: 12/30/2014 1:27:25PM CERS ID: 10185907 <br /> Submitted by:john origone Email origone@sbcglobal.net Facility 1D in CERS FA0017106 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0013947 <br /> Owner name ORIGONE RANCH ORIGONE RANCH 111 <br /> Mailing address 5261 N HWY 99 5261 N HWY 99 113 <br /> STOCKTON, CA 95215 STOCKTON, CA 95212 114: 115, 116 <br /> Work phone 209-952-3306 2099523306 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017106 <br /> Facility name ORIGONE RANCH ORIGONE RANCH 3 <br /> Site address 5261 N HWY 99 5261 N HWY 99 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95212 95212 105 <br /> Facility phone 209-952-3306 (209) 952-3306 0 102 <br /> Facility mailing address 5261 N HWY 99 5261 N HWY 99 1088 <br /> STOCKTON, CA 95215 STOCKTON, CA 95212 106b, 108c.10sd <br /> BILLING INFORMATION <br /> Contact name ORIGONE RANCH ORIGONE RANCH 140 <br /> Address 5261 N HWY 99 5261 N HWY 99 143 <br /> STOCKTON, CA 95215 STOCKTON, CA 95212 144, 145, 146 <br /> Contact phone 209-952-3306 2099523306 141 <br /> Contact email origone@sbcglobal.net ',. origone@sbcglobal.net 142 <br /> Mail invoices to Owitier J; <br /> Program record [ ] HMBP [ ] SQG HW [ J LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] 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 CFRS Integration Wizard by: Date: 1 `� <br /> Accounting: Reviewed by: 44' Date: ✓x D / Clerical: ) File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified 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 PRO525291 FATINAH ZAREEF Active [ ] [ ] <br /> 2220-SM H1N GEN <5 TONS/YR PRO530588 FATINAH ZAREEF Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0530587 FATINAH ZARFFF Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0532523 not assigned Inactive [ ] [ ] <br />