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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/22/2015 <br /> Submitted on: 12/22/2015 10:38:23AM CERS ID: 10614352 <br /> Submitted by: Jose Valdez Email:jose.valdez6600@broncowine.com Facility ID in CERS: incorrect <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 OW0002070 <br /> Owner name West Coast Grape Farming, Inc. WEST COAST GRAPE FARMING INC 111 <br /> Mailing address 6342 Bystrum Road 6342 BYSTRUM ROAD 113 <br /> Ceres, CA 95307 CERES, CA 95307 114, 115, 116 <br /> Work phone 209-272-3000 209-272-3000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0002750 <br /> Facility name March Lane Vineyards March Lane Vineyards 3 <br /> Site address 5000 Brookside Rd 6501 Brookside Rd 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95219 95219 105 <br /> Facility phone 209-272-3000 209-272-3000 102 <br /> Facility mailing address 6342 Bystrum Road 6342 BYSTRUM ROAD 108a <br /> Ceres, CA 95307 CERES, CA 95307 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name MARCH LANE VINEYARDS FRANK CANELA 140 <br /> Address 6342 Bystrum Road P.O. BOX 488 143 <br /> Ceres, CA 95307 CERES, CA 95307 144, 145, 146 <br /> Contact phone 209-272-3035 209-272-3035 141 <br /> Contact email frank.canela@broncowine.com frank.canela@broncowine.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG HW [ ] RCRA HW New PR#: 7 o SLA O (o S 1 <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: 1415 <br /> Assigned to: N N I Oen <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: 1 a•la 't) <br /> ----------------------------------------- <br /> Accounting: Reviewed by:�Date: P, Z3 15 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] 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 /> 1220-SM HW GEN<5 TONS/YR PR0539817 FATINAH ZAREEF Active [ ] [ ] <br /> 2755-EMPLOYEE HOUSING-SEASONAL<180 DAYS PR0270016 CARL BORGMAN Inactive [ ] [ ] <br /> v \ �tM ��OfIFSS 1n] QA4LC� G�- <br />