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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/17/2014 <br /> Submitted on: 2/12/2014 5:07:13PM CERS ID: 10180547 <br /> Submitted by: Bruce Fry Email: brucefry@mohrfry.com Facility ID in CERS: FA0000190 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000157 <br /> Owner name FRY, MARIAN Bruce Fry 111 <br /> Mailing address PO BOX 97 22000 Lower Sacramento Road 113 <br /> MT EDEN, CA 94557 Acampo, CA 95220 114, 115,116 <br /> Work phone 415-782-4608 2093343808 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0000190 <br /> Facility name MOHR-FRY RANCHES 39-45 RANCH 50 3 <br /> Site address 22000 N LOWER SACRAMENTO RD 22000 N LOWER SACRAMENTO RD 103 <br /> City ACAMPO ACAMPO 104 <br /> Zip code 95220 95220 105 <br /> Facility phone 209-334-3808 (209) 334-3808 102 <br /> Facility mailing address 12609 N WEST LN 12609 N WEST LN 108a <br /> LODI, CA 95240 LODI, CA 95240 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name MOHR-FRY RANCHES 39-45 Fry&Son LLC 140 <br /> Address 12609 N WEST LN 12609 N WEST LN 143 <br /> LODI, CA 95240 LODI, CA 95240 144, 145, 146 <br /> Contact phone 415-782-4608 2093343808 141 <br /> Contact email 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG 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: kAMlDate: (O' 1 1.1 1 <br /> Accounting: Reviewed by: Date: I Clerical: [/Fe [ ] Relabel file [ ] Create new file <br /> [ ] Acc ' ed— [ ] Surch verified By: Date: <br /> ---- --- <br /> --------------------------- <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 PRO525957 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2755-EMPLOYEE HOUSING-SEASONAL<180 DAYS PR0270045 OMRAN SOOD Inactive [ ] [ ] <br /> 2840-AST EXEMPT FAC < 1,320 GAL PRO530419 WILLY NG Active,Exempt [ ] [ ] <br />