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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/13/2015 <br /> Submitted on: 12/3012014 1:27:25PM CERS I'D: 10185907 <br /> Submitted by: john origone Email: origone@sbcglobal.net Facility ID in CERS: FA0017106 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0013947 <br /> Owner name ORIGONE RANCH ORIGONE RANCH 111 <br /> Mailing address 5261 N HWY 99 5261 N HWY 99 113 <br /> STOCKTON, CA 95215 STOCKTON, CA 95212 114, 115, 116 <br /> Work phone 209-952-3306 2099523306 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017106 <br /> Facility name ORIGONE RANCH ORIGONE RANCH 3 <br /> Site address 5261 N HWY 99 5261 N HWY 99 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95212 95212 105 <br /> Facility phone 209-952-3306 (209) 952-3306 0 102 <br /> Facility mailing address 5261 N HWY 99 5261 N HWY 99 108a <br /> STOCKTON, CA 95215 STOCKTON, CA 95212 108e, 108c, 1084 <br /> BILLING INFORMATION <br /> Contact name ORIGONL RANCH ORIGONE RANCH 140 <br /> Address 5261 N HWY 99 5261 N HWY 99 143 <br /> STOCKTON, CA 95215 STOCKTON, CA 95212 144, 145. 146 <br /> Contact phone 209-952-3306 2099523306 141 <br /> Contact email origone@sbcglobal.net origone@sbcglobal.net 142 <br /> Mail invoices to Ow <br /> tler <br /> Program record [ ] HMBP [ ] SOG 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 [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: �• 1� ` <br /> Accounting: Reviewed by: Date: ✓� D / Clerical: ; ] Fife [ ] Relabelfile [ ] 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 PR0525291 FATINAH ZAREEF Active [ ] [ ] <br /> 2220-SM HW GEN t5 TONS/YR PR0530588 FATINAH ZAREEF Active [ ] [ <br /> 2830-AST FAC -SPCC EXEMPT PR0530587 FATINAH ZAREEF Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0532523 not assigned Inactive [ ] [ <br />