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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/5/2015 <br /> Submitted on: 12/31/2014 12:15:50PM CERS ID: 10181639 <br /> Submitted by: Emory chow Email: echow@vctree.com Facility ID in CERS: FA0004500 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0003415 <br /> Owner name VALLEY CREST TREE COMPANY Valley Crest Companies 111 <br /> Mailing address PO BOX 289 28915 FUNCK RD 113 <br /> FARMINGTON, CA 95230-0289 FARMINGTON, CA 95230 114, 115, 11E <br /> Work phone 209-886-5511 2098865511 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0004500 <br /> Facility name VALLEY CREST TREE COMPANY VALLEY CREST TREE COMPANY 3 <br /> Site address 28915 FUNCK RD 28915 FUNCK RD 103 <br /> City FARMINGTON 104 <br /> ZIP code 95230 95230 105 <br /> Facility phone 209-886-5511 2098865511 102 <br /> Facility mailing address PO BOX 289 FARMINGTON 28915 funck road 108a <br /> FARMINGTON, CA 95230-0289 farmington, CA 95230 108b,108c, 108 <br /> BILLING INFORMATION <br /> Contact name VALLEY CREST TREE COMPANY emory 140 <br /> Address PO BOX 289 28915 funck road 143 <br /> FARMINGTON, CA 95230-0289 farmington, CA 95230 144, 145, 14E <br /> Contact phone 209-886-5551 9254374964 141 <br /> Contact email echow@vctree.com 142 <br /> Mail invoices to Owner <br /> Program record [ ] HMBP [ ] SOG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] 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: Dater a,, <br /> Accounting: Reviewed by: Date: I 311 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified 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 PR0525793 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2220-SM HW GEN <5 TONS/YR PRO530613 JEFFREY WONG Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0530612 JEFFREY WONG Active [ ] [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PR0535383 HARPRIT MATTU Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534157 not assigned Inactive [ ] [ ] <br />