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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Changes to EnvisionConnect by CERS Integration Wizard Date run: 4/21/2017 Submitted on: 4/6/2017 6:09:05PM CERS ID: 10416031 Submitted by: George Vierra Email: gardngirl60@aol.com Facility ID in CERS: FA0002804 Information prior to CIW processing Information after CIW processing CERS OWNER INFORMATION (current EC database) (current submittal) field Number of Facilities for this Owner: 4 Owner ID OW0002226 Owner name GEORGE VIERRA GEORGE VIERRA 111 Mailing address PO BOX 317 PO BOX 317 113 HOLT, CA 95234 HOLT, CA 95234 114, 115, 116 Work phone 209-482-4293 209 4824293 112 FACILITY FILE INFORMATION Facility ID FA0002804 Facility name GV FARMS GV Farms 3 Site address 8181 W HWY 4 8181 W Highway 4 103 City STOCKTON Stockton 104 ZIP code 95206 95206 105 Facility phone 209-482-4293 209 4824293 102 Facility mailing address PO BOX 317 PO BOX 317 108a HOLT, CA 95234 HOLT, CA 95234 108b,108c,1084 BILLING INFORMATION Contact name GV FARMS GEORGE VIERRA 140 Address PO BOX 317 PO BOX 317 143 HOLT, CA 95234 HOLT, CA 95234 144, 145, 146 Contact phone Not Specified 209 4824293 141 Contact email georgevierra@aol.com 142 Mail invoices to Account Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ) RCRA HW New PRM created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing Processed through CERS Integration Wizard by: 0"r' q-- Date: q-A-4-7 Accounting: Reviewed by: 1.1a Date: ? Clerical: [ ] File [ ] Relabel file [ ] Create new file [ ] Acct billed [ ] Surcharge verified By: Date: ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Record ID Employee name Status Reactivated Inactivated 1958-HM-Farm Operations 4 chem units PRO539270 MUNIAPPA NAIDU Active [ ] [ ] 2220-SM HW GEN<5 TONS/YR PR0539269 CESAR RUVALCABA Active [ ] [ ] 2830-AST FAC -SPCC EXEMPT PR0539792 STACY RIVERA Active [ ] [ ] 2765-EMPLOYEE HOUSING-PERMANENT>180 DAYS PR0270053 OMRAN SOOD Inactive [ ] [ ]