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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 12/7/2015 <br /> Submitted on: 12/7/2015 10:21:50AM CERS ID: 10185571 <br /> Submitted by: Anthony Enos Email: pdoxilvr@gmail.com Facility ID in CERS: FA0016887 <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 OW0013728 <br /> Owner name ABA FARMS ABA FARMS 111 <br /> Mailing address 16505 S TRACY BLVD 16505 S TRACY BLVD 113 <br /> TRACY, CA 95304 TRACY, CA 95304 114, 115, 116 <br /> Work phone 209-835-0406 209-835-0406 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016887 <br /> Facility name ABA FARMS ABA FARMS 3 <br /> Site address 9447 HOWARD RD 9447 HOWARD RD 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 209-835-0406 (209) 835-0406 0 102 <br /> Facility mailing address 16505 S TRACY BLVD 16505 S TRACY BLVD 108a <br /> TRACY, CA 95304 TRACY, CA 95304 10eb,10ec,10ed <br /> BILLING INFORMATION <br /> Contact name ABA FARMS ABA FARMS 140 <br /> Address 16505 S TRACY BLVD 16505 TRACY BLVD 143 <br /> TRACY, CA 95304 STOCKTON, CA 9��' !!!��/ 144, 145, 146 <br /> Contact phone 209-835-0406 209-835-0406 141 <br /> Contact email 'r/I , 1 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG 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 [ j exempt from billing <br /> Processed through CERS Integration Wizard by: OA Date: t 1 -) t <br /> Accounting: Reviewed by: � Date: l2q`01S 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 /> 2220-SM HW GEN<5 TONS/YR PR0539996 MICHELLE HENRY Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0530352 VICKI MCCARTNEY Active [ ] � <br /> 1958-HM-Farm Operations PRO525072 MUNIAPPA NAIDU Inactive [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO531856 not assigned Inactive [ ] [ ] <br /> {1PS� <br /> +bcai5 1320 �jGllw.� <br />