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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 11/28/2016 <br /> Submitted on: 11/11/2016 7:37:32AM CERS ID: 10687723 <br /> Submitted by: Istvan Deli Email: istvan@grimaudfarms.com Facility ID in CERS: FA0023565 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 1 <br /> Owner ID OW0021856 <br /> Owner name Howard Chan Howard Chan 111 <br /> Mailing address 1320-A S Aurora Street 1320-A S Aurora Street 113 <br /> Stockton, CA 95206 Stockton, CA 95206 114, 115, 116 <br /> Work phone 209-466-3200 209-466-3200 xt112 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0023565 <br /> Facility name DUPONT MARKET, INC DBA GRIMAUD FP Dupont Market, Inc. dba Grimaud Farms 3 <br /> Site address 1320 S AURORA ST STE A 1320 S Aurora St Ste A 103 <br /> City STOCKTON Stockton 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209-466-3200 209-466-3200xt112 102 <br /> Facility mailing address 1320-A S Aurora Street 1320-A S Aurora Street 108a <br /> Stockton, CA 95206 Stockton, CA 95206 108b, 108c.10ad <br /> BILLING INFORMATION <br /> Contact name DUPONT MARKET, INC DBA GRIMAUD FP Howard Chan 140 <br /> Address 1320-A S Aurora Street 1320-A S Aurora Street 143 <br /> Stockton, CA 95206 Stockton, CA 95206 144, 145, 146 <br /> Contact phone Not Specified 209-466-3200 xt 112 141 <br /> Contact email howard@grimaudfarms.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ j prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: 1 Date: 1112V/I L <br /> - - - -- - ------- ----- - - - -- - -- - - - <br /> Accounting: Reviewed by: Date: W'50/14''50/14 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ j Acct billed [ ] Surcharge verified By: Date: <br /> - - - --- -- ----- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PR0541152 ROBERT LOPEZ Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR PRO541203 ONE VACANTI Active [ ] [ ] <br />