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SAN JOAQUIN f, UNTY ENVIRONMENTAL HEALTH DCPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 7/17/2 14 <br /> Submitted on: 3/3/2014 2:27:16PM CERS ID: 10186625 <br /> Submitted by: Lagorio Brothers Email: lagoriobros@verizon.net Facility ID in CERS: FA0017545 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0014386 <br /> Owner name LAGORIO BROS FARMS LAGORIO BROS FARMS 111 <br /> Mailing address 20001 E FLOOD RD 20001 E FLOOD RD 113 <br /> LINDEN, CA 95236 LINDEN, CA 95236 114, 115, 116 <br /> Work phone (209) 887-2141 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017545 <br /> Facility name LAGORIO BROS FARMS LAGORIO BROS FARMS 3 <br /> Site address 19108 E TOBACCO RD 19108 E TOBACCO RD 103 <br /> City LINDEN LINDEN 104 <br /> Zip code 95236 95236 105 <br /> Facility phone 209-887-2141 (209) 887-2141 0 102 <br /> Facility mailing address 20001 E FLOOD RD 18600 Tobacco Road 108a <br /> LINDEN, CA 95236 LINDEN, CA 95236 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name LAGORIO BROS FARMS LAGORIO BROS FARMS 140 <br /> Address 20149 E FLOOD RD 20149 E FLOOD RD 143 <br /> LINDEN, CA 95236 LINDEN, CA 95236 144, 145, 146 <br /> Contact phone Not Specified (209) 887-2141 141 <br /> Contact email 142 <br /> Mail invoices to 0rr6r_ f= r_ <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: Date: <br /> Accounting: Reviewed by: �Date: -(D Clerical: [�_File [ ] Relabel file [ ] Create new file <br /> Ac t-bilTed Surchar e-veri lef d' B : Date: <br /> ------- ��--- [ ] <br /> 9 Y <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 PR0525730 not assigned Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PR0530611 JEFFREY WONG Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0530610 JEFFREY WONG Active, Exempt [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE F PR0533141 not assigned Inactive [ ] [ ] <br />