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SAN JOAQUhm COUNTY ENVIRONMENTAL HEALTH uEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 6/23/2014 <br />Submitted on: 3/28/2014 8:32:25PM <br />Submitted by: john veenstra Email: veenstrafarming@gmail.com <br />CERS ID: 10182049 <br />Facility ID in CERS: FA0006228 <br />Information prior to CIW processing <br />Information after CIW processing <br />CERS <br />OWNER INFORMATION <br />(current EC database) <br />(current submittal) <br />field <br />Owner ID <br />OW0004963 <br />Owner name <br />VEENSTRA FARMING <br />jeann Veenstra Fy9kmImf, <br />111 <br />Mailing address <br />15863 SEXTON RD <br />15863 SEXTON RD <br />113 <br />ESCALON, CA 95320 <br />ESCALON, CA 95320 <br />114, 115, 116 <br />Work phone <br />(209) 838-2894 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0006228 <br />Facility name <br />VEENSTRA FARMING <br />VEENSTRA FARMING <br />3 <br />Site address <br />15863 S SEXTON RD <br />15863 S SEXTON RD <br />103 <br />City <br />ESCALON <br />ESCALON <br />104 <br />Zip code <br />95320 <br />95320 <br />105 <br />Facility phone <br />209-838-2894 <br />(209) 838-2894 <br />102 <br />Facility mailing address <br />15863 SEXTON RD <br />15863 SEXTON RD <br />108a <br />ESCALON, CA 95320 <br />ESCALON, CA 95320 <br />108b, 1o8c, 1084 <br />BILLING INFORMATION <br />Contact name <br />VEENSTRA FARMING <br />VEENSTRA FARMING <br />140 <br />Address <br />15863 SEXTON RD <br />15863 SEXTON RD <br />143 <br />ESCALON, CA 95320 <br />ESCALON, CA 95320 <br />144, 145, 146 <br />Contact phone <br />209-838-2894 <br />(209) 838-2894 <br />141 <br />Contact email <br />142 <br />Mail invoices to <br />Owner <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br />created [ ] Tiered permit/ <br />APSA [ ] CalARP [ ] UST New PE: 2iS3 ri <br />/ Assigned to: (VLAN'I-D <br />Please bill: ull calendar year [ ] prorate this calendar year [ ] next calendar year /exempt from billing <br />Processed through CERS Integration Wizard by: w"' Date: ' <br />Accounting: Reviewed by.- Date: 07 Clerical: [)4ile [ ] Relabel file jV(Create new file <br />[ ] Acct billed [ ] Surcharge ver fied 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 PR0525906 not assigned Active [ ] [ ] <br />2221 - USED OIL ONLY - <5 TONS/YR PR0538467 ELENA MANZO Active [ ] [ ] <br />2333 - FARM UST #1 FACILITY - obsolete PR0504513 ALISON YOUNGBLOOD Inactive [ ] [ ] <br />