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SAN JOAQUIN .,OUNTY ENVIRONMENTAL HEALTH ICEPARTMENT Changes to EnvisionConnect by CERS Integration Wizard Date run: 12/3/2015 Submitted on: 12/2/2015 12:45:02PM CERS ID: 10186005 Submitted by: james molles Email: jsmolles@yahoo.com Facility ID in CERS: FA0017168 OWNER INFORMATION Owner ID Owner name Mailing address Work phone Information prior to CIW processing (current EC database) Number of Facilities for this Owner: 1 OW0014009 MOLLES VINEYARDS 3747 W WOODBRIDGE RD LODI, CA 95242 209-329-3671 FACILITY FILE INFORMATION Facility ID FA0017168 Facility name MOLLES VINEYARDS Site address 3747 W WOODBRIDGE RD City LODI ZIP code 95242 Facility phone 209-329-3671 Facility mailing address 3747 W WOODBRIDGE RD Information after CIW processing CERS (current submittal) field james molles 111 3747 W WOODBRIDGE RD 113 LODI, CA 95242 114, 115, 116 209 329 3671 112 MOLLES VINEYARDS 3 3747 W WOODBRIDGE RD 103 LODI 104 95242 105 none 102 3747 W WOODBRIDGE RD 108a LODI, CA 95242 108b, 108c, 108d james molles 140 3747 W WOODBRIDGE RD 143 LODI, CA 95242 144, 145, 146 209 329 3671 141 jsmolles@yahoo.com 142 Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PR#: _ New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ j exempt from billing Processed through CERS Integration Wizard by: Vim"' Date: ] 1?' I -------------------------------------------------- � Accounting: Reviewed by: ' Date: 1 L- Clerical: [ ] File [ ] Relabel file [ ] Create new file [ ] Acct billed ( ] Surcharge verified By: Date: ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Program Element and Description Record ID Employee name Status Reactivated Inactivated 1958 - HM -Farm Operations PR0525353 MUNIAPPA NAIDU Active [ ] [ ] 2220 - SM HW GEN <5 TONS/YR PR0529633 ARIS VELOSO Active [ ] [ ] 2830 - AST FAC - SPCC EXEMPT PR0529632 ARIS VELOSO Active [ ] ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0531270 not assigned Inactive [ ] [ ] CLr'� kJin" '( lr�vA) to Af sA C-NEv� ;N&-(" L jx,20 , LODI, CA 95242 BILLING INFORMATION Contact name MOLLES VINEYARDS Address 3747 W WOODBRIDGE RD LODI, CA 95242 Contact phone 209-329-3671 Contact email Mail invoices to Account Information after CIW processing CERS (current submittal) field james molles 111 3747 W WOODBRIDGE RD 113 LODI, CA 95242 114, 115, 116 209 329 3671 112 MOLLES VINEYARDS 3 3747 W WOODBRIDGE RD 103 LODI 104 95242 105 none 102 3747 W WOODBRIDGE RD 108a LODI, CA 95242 108b, 108c, 108d james molles 140 3747 W WOODBRIDGE RD 143 LODI, CA 95242 144, 145, 146 209 329 3671 141 jsmolles@yahoo.com 142 Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PR#: _ New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ j exempt from billing Processed through CERS Integration Wizard by: Vim"' Date: ] 1?' I -------------------------------------------------- � Accounting: Reviewed by: ' Date: 1 L- Clerical: [ ] File [ ] Relabel file [ ] Create new file [ ] Acct billed ( ] Surcharge verified By: Date: ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Program Element and Description Record ID Employee name Status Reactivated Inactivated 1958 - HM -Farm Operations PR0525353 MUNIAPPA NAIDU Active [ ] [ ] 2220 - SM HW GEN <5 TONS/YR PR0529633 ARIS VELOSO Active [ ] [ ] 2830 - AST FAC - SPCC EXEMPT PR0529632 ARIS VELOSO Active [ ] ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0531270 not assigned Inactive [ ] [ ] CLr'� kJin" '( lr�vA) to Af sA C-NEv� ;N&-(" L jx,20 ,