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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 8/10/2018 <br />Submitted: 1/8/2018 0:27:58AM CERS ID: 10753378 <br />Submitted by: Fry mail: brucefry@mohrfry.com Facility ID in CERS: incorrect <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 />W00234 <br />Bert d Alfred Andrews Family Trust <br />76 James <br />Atherton, CA 94027 <br />650-326-8226 <br />FACILITY FILE INFORMATION <br />Information after CIW processing CERS <br />(current submittal) field <br />Robert and Alfreda Andrews Family Trust 111 <br />76 James 113 <br />Atherton, CA 94027 114, 115, 116 <br />6503268226 112 <br />Facility ID <br />002480 <br />Facility name <br />R 0 <br />RANCH 60 <br />3 <br />Site address <br />2000 W Peltier Rd <br />2000 W Peltier Rd <br />103 <br />City <br />Lodi <br />Lodi <br />104 <br />ZIP code <br />95242 <br />95242 <br />105 <br />Facility phone <br />209-334-3808 <br />2093343808 <br />102 <br />Facility mailing address <br />12609 N. West Lane <br />12609 N. West Lane <br />108a <br />Lodi, CA 95240 <br />Lodi, CA 95240 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name <br />Mohr -Fry Ranches <br />Mohr -Fry Ranches <br />140 <br />Address <br />12609 N. West Lane <br />12609 N. West Lane <br />143 <br />Lodi, CA 95240 <br />Lodi, CA 95240 <br />144, 145, 146 <br />Contact phone <br />209-334-3808 <br />2093343808 <br />141 <br />Contact email <br />142 <br />Mail invoices to <br />Account <br />Program record [:4HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: P0QQ"'36!4 <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: lq)-1 <br />Assigned to: Ltr,%A <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: ° �� 1' Dater <br />Accounting: Rev ewed by: _ b Date: g I ? �I 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 />1921 - HMBP-Regular-Primary Location 1 chem un s PR0543649 JAMIE LIMA Active [ ] [ ] <br />lN,o �� �,2 .2_7 <br />