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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 2/13/2017 <br />Submitted on: 2/7/2017 10:30:42AM <br />Submitted by: jerry loogman Email: loogmanranch@clearwire.net <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 />OW0013767 <br />LOOGMAN RANCH <br />18299 RIVER RD <br />RIPON, CA 95366 <br />209-596-5974 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0016926 <br />Facility name <br />LOOGMAN RANCH <br />Site address <br />18299 RIVER RD <br />City <br />RIPON <br />ZIP code <br />95366 <br />Facility phone <br />209-596-5974 <br />Facility mailing address <br />18299 RIVER RD <br />RIPON, CA 95366 <br />BILLING INFORMATION <br />Contact name <br />LOOGMAN RANCH <br />Address <br />18299 RIVER RD <br />RIPON, CA 95366 <br />Contact phone <br />209-596-5974 <br />Contact email <br />loogmanranch@clearwire.net <br />Mail invoices to <br />Account <br />CERS ID: 10185631 <br />Facility ID in CERS: FA0016926 <br />Information after CIW processing CERS <br />(current submittal) field <br />LOOGMAN RANCH 111 <br />18299 RIVER RD 113 <br />RIPON, CA 95366 114, 115, 116 <br />(209)596-5974 112 <br />LOOGMAN RANCH <br />3 <br />18299 RIVER RD <br />103 <br />RIPON <br />104 <br />95366 <br />105 <br />(209) 596-5974 0 <br />102 <br />18299 RIVER RD 108a <br />RIPON, CA 95366 108b, 108c, 108d <br />LOOGMAN RANCH 140 <br />18299 RIVER RD 143 <br />RIPON, CA 95366 144, 145, 146 <br />(209)596-5974 141 <br />loogmanranch@gmail.com 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 <br />lIcalendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by. �X` Date: <br />Accounting: Reviewed by: t4✓ Date: a/J5117 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 PR0525111 MUNIAPPA NAIDU Active [ ] G T <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PRO534651 not assigned Inactive [ ] [ ] <br />CJ \ C 'i t �,1A (i,M 1 1- 1 P1Wl, [ ry Q C, A -Tc—( <br />` T <br />