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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT ,y) /� <br /> Changes to EnvisionConnect by CERS Integration Wizard V V J <br /> Date run: 7/25/2014 <br /> Submitted on: 2/14/2013 12:26:55PM CERS ID: 10412008 <br /> Submitted by: Glenn Goold Email: grgoold@yahoo.com Facility ID in CERS: <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0013925 <br /> Owner name Glenn Goold Glenn Goold 111 <br /> Mailing address PO Box 759 PO Box 759 113 <br /> Linden, CA 95235 Linden, CA 95235 114,115, 116 <br /> Work phone 209-931-2310 209 931 2310 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017084 <br /> Facility name Walnut Huller Walnut Huller 3 <br /> Site address 8408 N Beecher Rd 8408 N Beecher Rd 103 <br /> City Stockton Stockton 104 <br /> Zip code 95215 95215 105 <br /> Facility phone 209-931-2310 209 931 2310 102 <br /> Facility mailing address PO Box 759 PO Box 759 108a <br /> Linden, CA 95236 Linden, CA 95236 108b,1oac,toad <br /> BILLING INFORMATION <br /> Contact name Glenn Goold Glenn Goold 140 <br /> Address PO Box 759 PO Box 759 143 <br /> Linden, CA 95236 Linden, CA 95236 144, 145, 146 <br /> Contact phone 209-931-2310 209 931 2310 141 <br /> Contact email grgoold@yahoold.com grgoold@yahoold.com 142 <br /> Mail invoices to Owner <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ j 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: <br /> ------------- — — �_ ���� ��------- ---- - -- <br /> Accounting: Reviewed by: Date: I I NL"[ Clerical: [File [ ] Relabel file [ ] Create new file <br /> [ ] billed [ ] Surch venfied _ -------By: --- Date_ <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Initctiyi4fed <br /> 1958-HM-Farm Operations PRO525269 JAMIE DE LA ROSA Active [ ] <br /> 2840-AST EXEMPT FAC <1,320 GAL PRO529056 JEFFREY WONG Active,Exempt [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE F PRO534767 not assigned Inactive [ ] [ ] <br />