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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 12/2/2016 <br />Submitted on: 11/21/2016 3:16:58PM CERS ID: 10186165 <br />Submitted by: Micheal Zolezzi Email: mrzolezzi@verizon.net Facility ID in CERS: FA0017260 <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 : 1 <br />OW0014101 <br />M&R ZOLEZZI <br />POBOX 39 <br />LINDEN, CA 95236 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0017260 <br />Facility name <br />M&R ZOLEZZI <br />Site address <br />17972 E BAKER RD <br />City <br />LINDEN <br />ZIP code <br />95236 <br />Facility phone <br />209-931-0291 <br />Facility mailing address <br />POBOX 39 <br />17972 E Baker Rd <br />LINDEN, CA 95236 <br />BILLING INFORMATION <br />104 <br />Contact name <br />M&R ZOLEZZI <br />Address <br />17787 E FRONT ST <br />PO BOX 772 <br />LINDEN, CA 95236 <br />Contact phone <br />Not Specified <br />Contact email <br />Mail invoices to <br />Owner <br />Information after CIW processing CERS <br />(current submittal) field <br />Richard Zolezzi et al 111 <br />PO BOX 772 113 <br />LINDEN, CA 95236 114, 115, 116 <br />209-482-0347 112 <br />M&R ZOLEZZI <br />3 <br />17972 E Baker Rd <br />103 <br />LINDEN <br />104 <br />95236 <br />105 <br />(209) 931-0291 <br />102 <br />PO BOX 772 <br />108a <br />LINDEN, CA 95236 <br />108b, 1080, 108d <br />Richard Zolezzi 140 <br />PO Box 772 143 <br />LINDEN, CA 95236 144, 145, 146 <br />209-482-0347 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 [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: WDate: k 0 <br />-- -----------------------------------------------f� <br />Accounting: Reviewed by: 0J Date: Z 1 1,a 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 />1958 - HM -Farm Operations 1 chem units PR0525445 MUNIAPPA NAIDU Active ( ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0533798 not assigned Inactive [ ] [ ] <br />