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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 2/22/2016 <br />Submitted on: 2/11/2015 2:51:15PM <br />Submitted by: Logan Robertson Email: loganrobertsonfarms@hotmail.com <br />FACILITY FILE INFORMATION <br />Facility ID <br />Information prior to CIW processing <br />OWNER INFORMATION <br />(current EC database) <br />Site address <br />Number of Facilities for this Owner : 1 <br />Owner ID <br />OW0004403 <br />Owner name <br />HAL ROBERTSON FARMS LLC <br />Mailing address <br />27337 S BANTA RD <br />Facility mailing address <br />TRACY, CA 95304 <br />Work phone <br />209-835-0542 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0005579 <br />Facility name <br />HAL ROBERTSON FARMS LLC <br />Site address <br />27337 S BANTA RD <br />City <br />TRACY <br />ZIP code <br />95304 <br />Facility phone <br />209-835-0542 <br />Facility mailing address <br />27337 S BANTA RD <br />TRACY, CA 95304 <br />BILLING INFORMATION <br />Contact name <br />HAL ROBERTSON FARMS LLC <br />Address <br />27337 S BANTA RD <br />TRACY, CA 95304 <br />Contact phone <br />209-835-0542 <br />Contact email <br />Mail invoices to <br />Account <br />CERS ID: 10181883 <br />Facility ID in CERS: FA0005579 <br />Information after CIW processing CERS <br />(current submittal) field <br />HAL ROBERTSON FARMS LLC 111 <br />27337 S BANTA RD 113 <br />TRACY, CA 95304 114, 115, 116 <br />2098350542 112 <br />HAL ROBERTSON FARMS LLC 3 <br />27337 S BANTA RD 103 <br />TRACY 104 <br />95304 105 <br />(209) 835-0542 102 <br />27337 S BANTA RD 108a <br />TRACY, CA 95304 108b,108c, 108d <br />HAL ROBERTSON FARMS LLC 140 <br />27337 S BANTA RD 143 <br />TRACY, CA 95304 144, 145, 146 <br />2098350542 141 <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: <br />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 Igtegration Wizard by: VA Date: `L <br />Accounting: Reviewed by: 1145 Date: y / Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed Vi 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 PR0525843 MUNIAPPA NAIDU Active [ ] [ ] <br />2221 - USED OIL ONLY - <5 TONS/YR PR0538462 VICKI MCCARTNEY Active [ ] [ ] <br />2333 - EXCLUDED UST FACILITY PR0502799 STEVE SASSON Inactive [ ] <br />2830 - AST FAC - SPCC EXEMPT PR0529299 VICKI MCCARTNEY Inactive [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532223 not assigned Inactive [ ] [ ] <br />