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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 11/10/2017 <br />Submitted on: 9/22/2017 2:00:36PM <br />Submitted by: Kellie Jacobs Email: kelliejacobs@gmail.com <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner: 2 <br />OW0004488 <br />VALLEY BREWING CO INC <br />PO BOX 77847 <br />STOCKTON, CA 95267 <br />209-406-3911 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0001688 <br />Facility name <br />VALLEY BREWING CO <br />Site address <br />157 W ADAMS ST <br />City <br />STOCKTON <br />ZIP code <br />95204 <br />Facility phone <br />209-464-2739 <br />Facility mailing address <br />157 W ADAMS ST <br />STOCKTON, CA 95204 <br />BILLING INFORMATION <br />Contact name <br />VALLEY BREWING CO INC <br />Address <br />PO BOX 77847 <br />STOCKTON, CA 95267 <br />Contact phone <br />209-406-3911 <br />Contact email <br />Mail invoices to <br />Account <br />CERS ID: 10180799 <br />Facility ID in CERS: FA0001688 <br />Information after CIW processing CERS <br />(current submittal) field <br />VALLEY BREWING CO INC 111 <br />PO BOX 77847 113 <br />STOCKTON, CA 95267 114, 115, 116 <br />209-406-3911 112 <br />VALLEY BREWING CO <br />3 <br />157 W Adams St <br />103 <br />Stockton <br />104 <br />95204 <br />105 <br />(209) 464-2739 0 <br />102 <br />157 W ADAMS ST <br />108a <br />STOCKTON, CA 95204 <br />108b, 108c, 1084 <br />VALLEY BREWING CO INC 140 <br />PO BOX 77847 143 <br />STOCKTON, CA 95267 144, 145, 146 <br />209-406-3911 141 <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: <br />New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] Inext calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: 07vn -- Date: <br />Accounting: Reviewed by: Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactivated Inactivated <br />1625 - RESTAURANT/BAR 51-100 SEATS PRO160514 MARIBEL FLOHRSCHUTZ Active [ ] [ ] <br />1949-. HMBP-0O2 Only Food Facility 1 chem units PR0537269 4 moi— �Rc.�._ :�"e.T Active [ ] [ ] <br />Lko-tv', A -j [�Ik `%C�V-rn I alnk OlL7�'15v%eil +0 R06A LPC'Z_ 6L5 Per S(A6M4,��. <br />A7w_W4 Grp W- c)-,9 -7 s3 � <br />