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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/20/2014 <br /> Submitted on: 1/14/2013 5:20:32PM CERS ID: 10180697 <br /> Submitted by: Scott Whiteley Email: rswhiteley@aol.com Facility ID in CERS: FA0001065 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000834 <br /> Owner name WHITELEY FARMS Scott Whiteley 111 <br /> Mailing address 21676 S AIRPORT WAY 21676 S AIRPORT WAY 113 <br /> MANTECA, CA 95337 MANTECA, CA 95337 114, 115, 116 <br /> Work phone (209)403-8066 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0001065 <br /> Facility name WHITELEY FARMS WHITELEY FARMS 3 <br /> Site address 21676 S AIRPORT WAY 21676 S AIRPORT WAY 103 <br /> City MANTECA MANTECA 104 <br /> Zip code 95337 95337 105 <br /> Facility phone 209-823-6104 (209)403-8066 102 <br /> Facility mailing address 21676 S AIRPORT WAY 21676 S AIRPORT WAY 108a <br /> MANTECA, CA 95337 MANTECA, CA 95337 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name WHITELEY FARMS Scott Whiteley 140 <br /> Address 21676 S AIRPORT WAY 21676 S AIRPORT WAY 143 <br /> MANTECA, CA 95337 MANTECA, CA 95337 144, 145, 146 <br /> Contact phone 209=823-6104 (209)403-8066 141 <br /> Contact email rswhiteley@aol.com 142 <br /> Mail invoices to Owner <br /> Program record [ ] HMBP [ ] SQG HW ( ] LQG 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 Wizard by: A01 Date: <br /> Accounting: Reviewed by: _EJL:Date: Clerical: [ ] File [ ] Relabel file ( ] Create new file <br /> [ ] Ac�FblAed [ ] Surch erified ____________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 PRO525798 not assigned Active [ ] [ ] <br /> 2840-AST EXEMPT FAC <1,320 GAL PRO528940 MUNIAPPA NAIDU Active, Exempt [ ] [ ] <br /> 4450-POULTRY RANCH 12,000-09,999 BIRDS PRO400021 ALAN BIEDERMANN Inactive [ ] [ ] <br />