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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 1112612014 <br /> Submitted on: 11121/2014 11:43:16AM CERS ID: 10185967 <br /> Submitted by: Richard Williams Email: djvin@sbcglobal.net Facility ID in CERS: FA0017144 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0013985 <br /> Owner name DICK WILLIAMS WILLIAMS VINEYAR DICK WILLIAMS WILLIAMS VINEYAR 111 <br /> Mailing address 6132 E WOODBRIDGE RD 6132 E WOODBRIDGE RD 113 <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 114, 115, 11E <br /> Work phone 209 333-0161 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017144 <br /> Facility name DICK WILLIAMS VINEYARDS DICK WILLIAMS VINEYARDS 3 <br /> Site address 179 E TAYLOR RD 179 E TAYLOR RD 103 <br /> City LODI LODI 104 <br /> ZIP code 95242 95242 105 <br /> Facility phone 209-333-0161 (209) 333-0161 0 102 <br /> Facility mailing address 6132 E WOODBRIDGE RD 6132 E WOODBRIDGE RD 108a <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 108b,108c, tae <br /> BILLING INFORMATION <br /> Contact name DICK WILLIAMS VINEYARDS DICK WILLIAMS VINEYARDS 140 <br /> Address 6132 E WOODBRIDGE RD 6132 E WOODBRIDGE RD 143 <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 144, 145, 14( <br /> Contact phone Not Specified 209 333-0161 141 <br /> Contact email 142 <br /> Mail invoices to GkNfw <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 <br /> /Wizard by: ""I Date: l Z6) <br /> Accounting: Reviewed by: ACX Date: l ql?� Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct) ed [ ] Surch 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 PR0525329 not assigned Active [ ] [ ] <br /> 2840-AST EXEMPT FAG < 1,320 GAL PR0530506 WILLY NG Inactive [ } [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO533851 not assigned Inactive [ ] [ ] <br />