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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/7/2015 <br /> Submitted on: 112/2015 8:33:17AM CERS ID: 10185269 <br /> Submitted by:james renton Email: harnsv ca clearwire.net <br /> Facility PD in CERS: FA0016706 <br /> Information prior to CIW processing Information after CIW Processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0013547 <br /> Owner name HARRIS VINEYARDS HARRIS VINEYARDS 111 <br /> Mailing address PO BOX 135 PO BOX 135 113 <br /> CLEMENTS, CA 95227 CLEMENTS, CA 95227 114, 115, 11EWork phone (209) 727-3262 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016706 <br /> Facility name HARRIS VINEYARDS HARRIS VINEYARDS 3 <br /> Site address 16400 E PELTIER 16400 E PELTIER 103 <br /> City ACAMPO 104 <br /> ZIP code 95220 95220 105 <br /> Facility phone 209-727-3262 (209) 727-3262 0 102 <br /> Facility mailing address PO BOX 135 ACAMPO PO BOX 135 108a <br /> CLEMENTS, CA 95227 CLEMENTS, CA 95227 108b, 108c, 10E <br /> BILLING INFORMATION <br /> Contact name HARRIS VINEYARDS HARRIS VINEYARDS 140 <br /> Address PO BOX 135 PO BOX 135 143 <br /> CLEMENTS, CA 95227 CLEMENTS, CA 95227 144, 145, 14E <br /> Contact phone Not Specified (209) 727-3262 141 <br /> Contact email 142 <br /> Mail invoices to Owiter <br /> Program record [ ] HMBP [ ] SOG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from bi[ling <br /> Processed through CERS Integration Wizard by: N1 Date: <br /> Accounting: Reviewed by: ( Date: I 1 g l Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed ( ] 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 PRO524891 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2221 -USED OIL ONLY-<5 TONSIYR PR0538523 ARIS VELOSO Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0530416 ARIS VELOSO Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0531747 not assigned Inactive [ ] [ ] <br />