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SAN JOAQUIiv COUNTY ENVIRONMENTAL HEALTH LiEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 7/9/2015 <br />Submitted on: 6/22/2015 11:23:24AM <br />Submitted by: juan calderon Email: juan.calderon@broncowine.com <br />FACILITY FILE INFORMATION <br />Facility ID <br />Information prior to CIW processing <br />Facility name <br />(current EC database) <br />OWNER INFORMATION <br />23201 N RAY RD <br />Owner ID <br />OW0013840 <br />Owner name <br />J&D VINEYARDS <br />Mailing address <br />15466 LINN RD <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI <br />LODI, CA 95240 <br />Work phone <br />Inactive [ ] [ ] <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0016999 <br />Facility name <br />J&D VINEYARDS <br />Site address <br />23201 N RAY RD <br />City <br />LODI <br />ZIP code <br />95242 <br />Facility phone <br />209-334-6072 <br />Facility mailing address 15466 LINN RD <br />LODI, CA 95240 <br />BILLING INFORMATION <br />Contact name J&D VINEYARDS <br />Address 23201 N RAY RD <br />LODI, CA 95242 <br />Contact phone Not Specified <br />Contact email <br />Mail invoices to Owner <br />CERS ID: 10614337 <br />Facility ID in CERS: incorrect <br />Information after CIW processing CERS <br />(current submittal) field <br />JD VINEYARDS - WEST COAST GRAPE F, 111 <br />P.O. BOX 488 113 <br />CERES, CA 95307 114, 115, 116 <br />209-272-3000 112 <br />JD Vineyards- West Coast Grape Farminc 3 <br />23201 N Ray Rd <br />103 <br />Lodi <br />104 <br />95242 <br />105 <br />209-272-3000 <br />102 <br />P.O. BOX 488 108a <br />CERES, CA 95307 108b, 108c, 108d <br />FRANK CANELA 140 <br />P.O. BOX 488 143 <br />CERES, CA 95307 144, 145, 146 <br />209-272-3035 141 <br />frank.canela@broncowine.com 142 <br />Program record [ ] HMBP -S�pSQG HW [ ] LQG HW [ ] RCRAHW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: a � <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: -; c s- <br />---- ----------------------- —--------- <br />Accounting: Revi ed by:Ije?Date: 7%J� Clerical: [ ]File [ ]Relabel file (]Create new file <br />Acct billed [ rge vers ied By: Date: <br />--------------------------------------------------- <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description <br />Record ID <br />Employee name <br />Status Reactivated Inactivated <br />2830 -AST FAC - SPCC EXEMPT <br />PRO530408 <br />ARIS VELOSO <br />Active, Exempt [ ] [ ] <br />1958 - HM -Farm Operations <br />PR0525184 <br />JAMIE DE LA ROSA <br />Inactive <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI <br />PRO533170 <br />not assigned <br />Inactive [ ] [ ] <br />At'fjyAj-t' 01411 <br />